A multicenter study on pain measurement among children with burns: assessment of reliability and validity of the POCIS and COMFORT scale

Burns are extremely painful. Pain is categorized into two categories:
background pain (pain at rest) and procedural pain (pain caused during
manipulation of wounded body parts). Children aged 0 to 4 years are not or
insufficiently capable of verbal indicating pain. For that reason, the
literature suggests the use of pain observation scales in order to assess pain
in this group of young children.
In the Netherlands there is no pain scale available that has been tested to
assess pain in children with burns. Pocis and Comfort scales were used to
assess post operative pain, which cannot be generalized to measure procedural
pain in children with burns. For that reason, it is necessary to examine pain
in the clinical setting in this specific group of children.

To assess validity and reliability of two pain observation scales in children
with burns aged 0 to 4 years. Moreover, nurses will be asked to judge
use-friendliness of the scales.
After completion of the study, one of the scales should be used daily to assess
pain in children admitted to a Dutch burns center.

During a period of one year, nurses will observe children between 0 and 4 years
of age using two pain observation scales. Pain observations will be performed
two times a day in rest and immediately after dressing change procedures are
completed.

Children who will be observed do not experience any hindrance.
Nurses will observe the children two times a day at rest and during wound
dressing changes. Wond dressing procedures do not have any other course
compared with standard care. Nurses rapport their observations after completion
of the procedure. There will not be any changes in standard pain care
procedures.