Elsevier

The Journal of Pain

Volume 19, Issue 6, June 2018, Pages 660-669
The Journal of Pain

The Psychometric Properties of the MBPS Scale Used to Assess Procedural Pain

https://doi.org/10.1016/j.jpain.2018.01.012Get rights and content
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Highlights

  • The Modified Behavioral Pain Scale (MBPS) was reliable for procedural pain use.

  • Although sensitive, the MBPS was not shown as specific for procedural pain.

  • There were concerns about the feasibility of the MBPS.

  • There are design limitations which make the MBPS unsuitable for procedural use.

Abstract

The Modified Behavioral Pain Scale (MBPS) was designed to assess procedural pain in infants and is considered valid for assessing immunization pain. The aim of this study was to assess the practical and psychometric properties of the MBPS when applied to other commonly performed procedures. Twenty-six clinicians independently applied the MBPS scale to segments of video collected from 100 infants and children aged 6 to 42 months undergoing 1 of 4 procedures in the emergency department. Positive correlation between MBPS and Visual Analogue Scale observer applied (VASobs) pain (r = .74) was shown and inter- and intrarater reliability coefficients were high (.87 and .89, respectively). Construct validity was shown by scale responsiveness to painful stimuli (4.6 times increase in scores across phases) and the capacity of the scale to distinguish between painful versus nonpainful procedures (P < .001). However, mean baseline scores for procedures were not 0 (likely a function of item descriptors for a “0” score) and the mean difference increased across phases for children with baseline scores >3, which was much lower than for children with scores <3 (P = .0001). Finally, 28% of scores changed after the second viewing of a video segment. The MBPS appears reliable and sensitive to procedural pain when applied by clinicians. Results question the capacity of the scale to differentiate between pain- and nonpain-related distress, the feasibility of this scale, and the appropriateness of item descriptors for medical procedures.

Perspective

This article presents the psychometric and practical properties of the MBPS applied to assess procedural pain. Identification of a suitable scale for this purpose will support improved pain management in infants and young children who undergo painful procedures.

Key words

Modified Behavioral Pain Scale
pain assessment
reliability
validation/validity
psychometric evaluation
pediatrics
infants

Cited by (0)

This work was supported by a Murdoch Children's Research Institute clinical research grant.

The authors have no conflicts of interest to declare.

Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.