Validating the Derbyshire Children's Hospital Pain Tool: a pilot study

Background : The Derbyshire Children's Hospital Paediatric Pain Chart (DPC) is the current pain assessment tool used at the Derbyshire Children's Hospital. It was originally devised as a simple pain tool for use in the clinical area, and it is applicable for use in children of all ages within the postoperative setting. The pain assessment chart encompasses pain assessment by utilizing facial expression, body movement and verbal expression. An exploratory study was performed to define its reliability and validity. Methods : The research nurse (V.P.) assessed 40 children aged 1-5 undergoing minor and intermediate surgery comparing the Toddler Preschooler Postoperative Pain Scale and the DPC. Assessments were performed preoperatively and for 4 h postoperatively. Any analgesia administered postoperatively was recorded. Results : All the children scored 0 preoperatively with both pain scales, thus demonstrating known groups validity. There were 116 dual assessments by the research nurse using both pain scales. There was a strong correlation (r = 0.89) demonstrating convergent validity. There was a significant correlation between 182 joint assessments by the research nurse (V.P.) and the nursing staff using the DPC (Spearmans rank correlation, 0.81) and the Cronbach alpha coefficient ranged from 0.83 to 0.98. Construct validity was demonstrated by a fall in the mean pain scores from 1.8 to 0.1 following analgesia in 19 children. Conclusions : This exploratory study suggests the DPC holds construct, convergent and known groups validity and is a reliable pain assessment tool for children aged 1-5 years undergoing minor and intermediate surgery.