Cross-cultural adaptation and translation of two pain assessment tools in children and adolescents

Objective: To translate, back-translate and cross-culturally adapt the content of the FLACC (Face, Legs, Activity, Cry, Consolability) and Faces Pain Scale-Revised (FPS-R) scales for the evaluation of pain in Brazilian young students and adolescents. Methods: The original scales in English were translated into Brazilian Portuguese. Scales thus obtained were back translated and reviewed. Cross-cultural adaptation included the submission of the reviewed version of the scales to 12 experts to obtain data on comprehensibility, appropriateness and acceptability. A pretest was carried out in a convenience sample (20 patients and 22 health care professionals) to assess the content of the scales. The cancer patients, 7-17 years of age, were receiving care at the outpatient department or in the pediatric ward of the National Cancer Institute. Results: After inclusion of the recommendations made by the different professionals who participated in the processes of translation, back-translation and content evaluation of the scales, pretesting showed that 90% and 100% of participants, respectively, understood the content of the scales; the mean score for comprehension ranged from 8.8 to 10.0 in a scale ranging from I to 10, with higher scores indicating better understanding. Conclusions: Both scales were found to be easily comprehensible for the evaluation of pain in Brazilian children and adolescents with cancer.