Cross-validation of the Children's and Infants' Postoperative Pain Scale in Brazilian Children

Abstract

Objective: To validate CHIPPS (Children's and Infants' Postoperative Pain Scale) in Brazilian children.

Background: Cross-validation is needed in order to apply this scale in a different language and culture.

Methods: We applied a Portuguese version of CHIPPS to 100 children aged 0 to 5 years. The scale was translated and tested for inter-rater reliability, internal consistency, and construct, content, and concurrent validity. The children's behavior was videotaped before, during and after a procedure in a primary care unit. Three observers then rated pain behavior from videotapes.

Results: The scale showed excellent inter-rater reliability (intraclass correlation coefficient: 0.89) and a very good internal consistency, with Cronbach's alpha of 0.86. The positive correlation between CHIPPS and Modified Behavior Pain Scale supports concurrent (criterion) validity (Spearman coefficient 0.70 before and 0.81 after vaccinations). Construct validity was determined by comparing the scores of each child before vaccination (without pain) and during the procedure (experiencing pain), and the difference in pain scores was statistically significant (Wilcoxon signed rank test; P < 0.001). Content validity (by expert review) was very good.

Conclusions: Based on the results obtained, we can infer that CHIPPS is a valid and reliable tool for Brazilian children aged 0 to 5 years old.