Abstract
BackgroundThis study evaluated the validity and reliability of the Italian version of the Non-Communicating Children’s Pain Checklist-Postoperative version (I-NCCPC-PV).MethodsThe original NCCPC-PV version was translated into Italian following the guidelines for “the translation, adaptation, and validation of instruments or scales for cross-cultural healthcare research”. We tested the Italian NCCPC-PV version (I-NCCPC-PV) in 40 children (3–18 years of age) with severe to profound Intellectual Disability and no verbal communication. Each child’s behavior was observed by a parent or caregiver and by an external observer in a quiet situation and a painful one. They independently assessed the child’s level of pain using the translated Italian version of the NCCPCPV (I-NCCPC-PV).ResultsThe results from 80 assessments showed that children’s behavioral signs differed significantly between painful and calm situations (p < 0.001). The inter-rater reliability was poor in a quiet condition (ICC 0.62) and fair in a painful situation (ICC 0.77). The inter-rater agreement was good in both calm and painful conditions (72.50% and 77.50% respectively).ConclusionThe Italian version of the NCCPC-PV (I-NCCPC-PV) can be used for pain assessment in children with Intellectual Disability who lack verbal communication.
Highlights
This study evaluated the validity and reliability of the Italian version of the Non-Communicating Children’s Pain Checklist-Postoperative version (I-NCCPC-PV)
The children were of 3–18 years of age, according to the original validation study of NCCPC-PV [12]
All the children were incapable of verbal communication due to severe to profound Intellectual Disability (ID)
Summary
This study evaluated the validity and reliability of the Italian version of the Non-Communicating Children’s Pain Checklist-Postoperative version (I-NCCPC-PV). Patients with ID experience pain more frequently than healthy children: they are at a high risk of chronic conditions and associated diseases which could evoke pain: muscular contractures, chronic constipation, gastro-esophageal reflux, hip-luxation, bone fractures and tooth decay. They frequently need invasive diagnostic and therapeutic procedures which can lead to stressful and painful situations, such as botulinum toxin injection, gastrointestinal endoscopy, stomatological treatment, blood. The lack of a valid and reliable Italian pain assessment tool makes it difficult for health professionals to evaluate a child’s pain and to provide effective pain treatment, and this results in poor pain management. Recent reports proved that children with ID undergoing surgery receive less opioid infusion in the perioperative period than children without ID [9,10,11]
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