Factors that Influence Coping with Chronic Noncancer Pain in European Countries: A Systematic Review of Measuring Instruments

Background and aimCoping can be defined as the cognitive efforts and behavioral practices that people develop in situations which they consider to be stressful. In people with Chronic Non-Cancer Pain (CNCP), coping is influenced by the biological, psychological, and socio-cultural resources available to them. The aim of this systematic review is to evaluate the psychometric properties of European measuring instruments related to coping with CNCP in non-hospitalized adults.Database and data treatmentThe review was conducted following the guidelines of the PRISMA Statement and the methodological framework of the Joanna Briggs Institute. The CINAHL, PubMed, Scopus, and Web of Science databases were searched by two reviewers independently. The analysis of psychometric properties was performed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist, and the risk of bias was analyzed using the Quality Assessment of Diagnostic Accuracy Study-2 (QUADAS-2) tool.ResultsThirty-six studies validated twenty-four different instruments. The Portuguese version of the Pain Beliefs and Perceptions Inventory (PBPI), which assess catastrophizing, and the Spanish version of the Roland-Morris Questionnaire (RMQ), which assess disability, are the instruments with the best methodological quality and bias control.ConclusionsThere are important gaps in the measurement of different aspects of pain coping, such as stress, social and family support, or self-care. Future studies could consider the creation of an instrument to comprehensively assess the resources that influence coping with chronic non-cancer pain.     

Instruments evaluating the quality of the clinical learning environment in nursing education: A systematic review of psychometric properties

BackgroundThe clinical learning environment is fundamental to nursing education paths, capable of affecting learning processes and outcomes. Several instruments have been developed in nursing education, aimed at evaluating the quality of the clinical learning environments; however, no systematic review of the psychometric properties and methodological quality of these studies has been performed to date.ObjectivesThe aims of the study were: 1) to identify validated instruments evaluating the clinical learning environments in nursing education; 2) to evaluate critically the methodological quality of the psychometric property estimation used; and 3) to compare psychometric properties across the instruments available.DesignA systematic review of the literature (using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines) and an evaluation of the methodological quality of psychometric properties (using the COnsensus-based Standards for the selection of health Measurement INstruments guidelines).Data sourcesThe Medline and CINAHL databases were searched. Eligible studies were those that satisfied the following criteria: a) validation studies of instruments evaluating the quality of clinical learning environments; b) in nursing education; c) published in English or Italian; d) before April 2016.Review methodsThe included studies were evaluated for the methodological quality of the psychometric properties measured and then compared in terms of both the psychometric properties and the methodological quality of the processes used.ResultsThe search strategy yielded a total of 26 studies and eight clinical learning environment evaluation instruments. A variety of psychometric properties have been estimated for each instrument, with differing qualities in the methodology used. Concept and construct validity were poorly assessed in terms of their significance and rarely judged by the target population (nursing students). Some properties were rarely considered (e.g., reliability, measurement error, criterion validity), whereas others were frequently estimated, but using different coefficients and statistical analyses (e.g., internal consistency, structural validity), thus rendering comparison across instruments difficult. Moreover, the methodological quality adopted in the property assessments was poor or fair in most studies, compromising the goodness of the psychometric values estimated.ConclusionsClinical learning placements represent the key strategies in educating the future nursing workforce: instruments evaluating the quality of the settings, as well as their capacity to promote significant learning, are strongly recommended. Studies estimating psychometric properties, using an increased quality of research methodologies are needed in order to support nursing educators in the process of clinical placements accreditation and quality improvement.     

Adaptation and Initial Validation of the Premature Infant Pain Profile–Revised (PIPP-R) in Brazil

BackgroundThe use of reliable pain assessment measures is essential for scoring and managing pain in infants. The Premature Infant Pain Profile (PIPP) is reliable and valid and has been recently revised. To adapt and validate the PIPP-R into Portuguese and to evaluate its psychometric properties are required to ensure maintenance of meaning and content.AimsThe aim of this study was to culturally adapt to Brazilian Portuguese and explore content validity and construct validity of the Premature Infant Pain Profile–Revised.DesignThis is a methodological study.Participants/SettingsTwo existing data sets of randomized clinical trials previously conducted were used to examine initial construct validity of the prefinal version of the Premature Infant Pain Profile–Revised.MethodsCross-cultural adaptation and validation occurred in four steps. Independent versions of the Premature Infant Pain Profile–Revised were produced, followed by the preparation of a synthetic version. Two back-translated versions were realized by professional translators. An expert committee evaluated idiomatic and semantic equivalence and clarity and relevance of the items. A content validity index was calculated. Finally, a consolidated prefinal version in Portuguese was then produced.ResultsNo difficulties in producing the material were reported. Semantic and idiomatic aspects were considered adequate, and content validity index was 1.0. Premature Infant Pain Profile and Premature Infant Pain Profile–Revised scores were highly correlated for pain after heel lancing and venipuncture (R² = 0.986, p < .001) and for pain associated with analgesic strategies (R² = 0.966-1.00, p < .001).ConclusionsThe Premature Infant Pain Profile–Revised was culturally adapted into Brazilian Portuguese. Appropriate content validity index was determined. Evidence of construct validity was also found. Future studies are warranted to explore the feasibility and other psychometric properties of using the Premature Infant Pain Profile–Revised translated and adapted into Brazilian Portuguese in the clinical setting.     

Measurement properties of patient-reported hand function measures in rheumatoid arthritis: a systematic review protocol

Background: Patient-reported outcome measures (PROMs) are commonly used to evaluate hand function in people with rheumatoid arthritis (RA). A decision will always need to be made about which appropriate PROMs to use. The present review therefore aims to describe the available hand function PROMs for use in people with RA by appraising their methodological quality and psychometric properties using a contemporaneous method.

Methods/design: The proposed systematic review will include published studies written in English, which report evidence for psychometric properties and/or practical properties of hand function PROMs in RA. Four major databases (MEDLINE, Embase, PsycINFO, and CINAHL) will be searched from inception to May 2019. A three-staged search strategy will be applied: (1) electronic bibliographic databases for published studies, (2) ‘named measures’ searching approach, and (3) reference lists of studies with included PROMs. The proposed systematic review will be conducted in compliance with the consensus-based standards for the selection of health measurement instruments (COSMIN) guideline for systematic review of PROMs. Accordingly, the methodological quality of the included studies will be assessed against the updated COSMIN risk of bias checklist, and each study’s results will be assessed for their psychometric quality.

Conclusion: The proposed systematic review seeks to provide rigour, and transparent evaluation of PROMs used to evaluate hand function in the RA population. The findings will provide clarity for healthcare professionals and researchers on the appropriate PROMs for hand function assessment. It will also provide a summary of hand function PROM recommendations for RA.     

Exploring the psychometric properties of self-report instruments used to measure health-related quality of life and subjective wellbeing of adolescents with intellectual disabilities: A Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) systematic review

Background

Studies that have systematically reviewed the psychometric properties of health-related quality of life (HRQoL) and subjective wellbeing instruments for adolescents with intellectual disabilities narrowly focus on disease or health-specific conditions. This review aimed to critically appraise the psychometric properties of self-report instruments used to measure HRQoL and subjective wellbeing of adolescents with intellectual disabilities.

Method

A systematic search was undertaken in four databases. The quality of the included studies and their psychometric properties was assessed according to the COnsensus-based Standards for the selection of health Measurement Instruments Risk of Bias checklist.

Results

Seven studies reported psychometric properties of five different instruments. Only one instrument identified as having potential to be recommended for use but requires further validation research to assess its quality for this population.

Conclusions

There is insufficient evidence to support the recommendation of a self-report instrument to assess HRQoL and subjective wellbeing of adolescents with intellectual disabilities.     

Instruments evaluating the quality of the clinical learning environment in nursing education: An updated systematic review

ObjectivesThe clinical learning environment offers meaningful learning opportunities for nursing students to apply theoretical knowledge to practice on actual or simulated patients. A previous systematic review assessed the quality of several instruments that evaluated the quality of clinical learning environments. This updated systematic review aimed to identify: any additional instruments that have been researched in the last 5 years, ii) the psychometric properties of available instruments and iii) the estimated comparable psychometric properties of the available instruments.Data sourcesMedline, CINAHL and Cochrane databasesReview methodsDatabases were searched from January 2016 to January 2023. Studies were included if they: a) validated instruments evaluating the experience and quality of clinical learning environments; b) assessed the pre-licensure nursing student experience; c) were published in English; and d) were published after April 2016. Two independent reviewers conducted title and abstract screening, full text screening, data extraction and methodological quality assessment. Any disagreements were resolved by consensus. A summary of the findings was tabulated using the same format as the initial review.ResultsAn additional 18 studies were found, which used seven different clinical learning environment evaluation instruments. Internal consistency and structural validity were the most frequently reported psychometric properties. In almost all studies, methodology for these properties were of sufficient quality according to the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) tool evaluation. Other properties were inconsistently reported, with differing qualities in the methodology. Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) remains the most translated and validated instrument across several countries.ConclusionsInstruments developed and validated using a systematic, transparent and high-quality methodology assist in accurately assessing the skills, attitudes and decision-making abilities of the preregistration level nursing student. These tools can be used in clinical placement accreditation and quality improvement of nursing education. The methodology for evaluation of the psychometric properties of instruments should be clearly described.     

Comparative systematic review of the psychometric properties of measures of illness perceptions in family members of individuals diagnosed with a chronic physical illness

Although illness perceptions have significant implications for psychological morbidity in those diagnosed with a physical illness, the strength of this relationship in their family members remains understudied. The validity of findings is dependent on the quality of the instruments used; therefore, it is essential that psychometrically robust measures of illness perceptions are available. The purpose of this systematic review was to identify, assess and compare the psychometric properties of instruments designed to measure illness perceptions in family members of individuals with chronic physical illnesses. A systematic search was conducted using MEDLINE, PubMed, CINAHL, Scopus and PsycINFO databases, and supplemented with forward and backward searches. Studies were included in the review if they described the development, adaptation or psychometric evaluation of an instrument designed to measure illness perceptions in family members of an individual with a chronic physical illness. The methodological quality of included studies was assessed using the COSMIN Risk of Bias checklist. The psychometric quality of instruments was evaluated using published quality assessment criteria. Eleven articles describing nine different instruments were included in the review. Almost all instruments were designed for parents of a child with a chronic illness. There was wide variation in the quality of methods used to develop, adapt or evaluate the instruments, and missing information restricted the evaluation of psychometric properties. Further validation is needed for all instruments before meaningful conclusions can be drawn. Findings indicate that measurement of illness perceptions in children or siblings of an individual with a chronic physical illness has been largely ignored. Future research addressing this gap would be an important addition to the current body of work examining illness perceptions in family members.     

Assessing health empowerment - Brazilian cross-cultural adaptation and validity testing of the health education impact questionnaire (heiQ) among people with chronic low back pain

BackgroundThere is no patient reported outcome measure available in Brazilian Portuguese to comprehensively assess outcomes following administration of patient education programs for people with chronic conditions.ObjectiveTo describe the cross-cultural adaptation and measurement properties of the Brazilian Portuguese version of the Health Education Impact Questionnaire (heiQ), a multidimensional questionnaire designed for the evaluation of patient education programs, which was tested in people with chronic low back pain (LBP).MethodsOne hundred thirty-seven individuals with non-specific chronic LBP (age: 38.7 ± 13.2) were enrolled in the study. The translation was performed according to international standards. Intraclass correlation coefficient (ICC) was used to assess test-retest reliability, Cronbach’s α to assess internal consistency, Pearson rank correlation to compare the heiQ scales with comparator scales, and confirmatory factor analysis (CFA) for structural validity.ResultsThe test-retest analysis yielded ICC values ranging from 0.75 to 0.91. Cronbach’s alphas for the seven scales ranged from 0.70 to 0.89. Significant correlations between affective and general health constructs and the heiQ scales (72%) were observed. For the majority of the scales, the CFA fit statistics showed to be good to excellent.ConclusionOverall, the Brazilian Portuguese version of the heiQ showed acceptable reliability, internal consistency, construct validity, and structural validity in individuals with chronic LBP. The heiQ scales may serve as direct outcomes to assess education and self-management programs for the Brazilian Portuguese speaker population.     

Assessment of activity limitations and participation restrictions with persons with chronic fatigue syndrome: a systematic review

Abstract

Purpose: To summarize measurement instruments used to evaluate activity limitations and participation restrictions in patients with chronic fatigue syndrome (CFS) and review the psychometric properties of these instruments. Method: General information of all included measurement instruments was extracted. The methodological quality was evaluated using the COSMIN checklist. Results of the measurement properties were rated based on the quality criteria of Terwee et?al. Finally, overall quality was defined per psychometric property and measurement instrument by use of the quality criteria by Schellingerhout et?al. Results: A total of 68 articles were identified of which eight evaluated the psychometric properties of a measurement instrument assessing activity limitations and participation restrictions. One disease-specific and 37 generic measurement instruments were found. Limited evidence was found for the psychometric properties and clinical usability of these instruments. However, the CFS-activities and participation questionnaire (APQ) is a disease-specific instrument with moderate content and construct validity. Conclusion: The psychometric properties of the reviewed measurement instruments to evaluate activity limitations and participation restrictions are not sufficiently evaluated. Future research is needed to evaluate the psychometric properties of the measurement instruments, including the other properties of the CFS-APQ. If it is necessary to use a measurement instrument, the CFS-APQ is recommended.

• Implications for Rehabilitation

• Chronic fatigue syndrome (CFS).

• Chronic fatigue syndrome causes activity limitations and participation restrictions in one or more areas of life.

• Standardized, reliable and valid measurement instruments are necessary to identify these limitations and restrictions.

• Currently, no measurement instrument is sufficiently evaluated with persons with CFS.

• If a measurement instrument is needed to identify activity limitations and participation restrictions with persons with CFS, it is recommended to use the CFS-APQ in clinical practice and scientific research.

     

Benefit finding in adult cancer populations: Psychometric properties and performance of existing instruments

PurposeTo analyse the psychometric properties and performance of existing instruments that aim to measure benefit finding in adult cancer populations.MethodsFour electronic databases were searched. The focus was to identify English language, peer-reviewed journal articles where benefit finding is assessed with adult cancer populations. The terms ‘benefit finding’, ‘cancer’, ‘instruments’, ‘scales’, and ‘adult’ were used in various combinations. The instruments were rated against established criteria for instrument construction, reliability, validity, and interpretability.ResultsSeventeen benefit finding instruments were reviewed. The instruments present a multifarious conceptualisation of the construct. Instrument structure is diverse. Several instruments (n = 4) reported on all the psychometric properties, but not interpretability. One instrument, the Stress-Related Growth Scale – Revised, additionally reported correlation statistics with another benefit finding instrument. Based on the information provided, the psychometric rigour of a number of instruments is yet to be established.ConclusionsOne instrument reported validation statistics for all the identified criteria. While existing instruments provide a range of operationalisations of the benefit finding concept and have been more or less used in previous research, a majority are in the early stages of development and require further validation work in adult cancer populations. Given the increasing interest in the role benefit finding in clinical practice, researchers are urged to use these instruments further and to report relevant validation statistics when using them.     

Comprehensive clinical sitting balance measures for individuals following stroke: a systematic review on the methodological quality

Purpose: The aim of this systematic review was to examine the psychometric properties of published clinical sitting measurement scales containing dynamic tasks in individuals following stroke.

Method: Databases, including Cumulative Index of Nursing and Allied Health Literature (CINAHL), MEDLINE, EMBASE, Cochrane, PubMed and Allied and Complementary Medicine Database (AMED) were searched from inception to December 2015. The search strategy included terms relating to sitting, balance and postural control. Two reviewers independently selected and extracted data from the identified articles and assessed the methodological quality of the papers using the COnsensus-based Standards for selection of health status Measurement INstruments (COSMIN) checklist.

Results: Fourteen clinical sitting measurement scales (39 papers) containing dynamic tasks met the inclusion criteria and various measurement properties were evaluated. The methodological quality of the majority of the included studies was rated as poor to fair using the COSMIN checklist, with common limitations including small sample size and inappropriate use of statistical methods.

Conclusions: This review was unable to identify measures with sufficient psychometric properties to enable recommendation as preferred tools. However, measures were identified that warrant further specific psychometric investigations to fulfil requirements for a high quality measure.

• Implications for Rehabilitation

• Fourteen clinical sitting balance scales containing dynamic tasks are available to measure sitting balance with individuals following stroke.

• No single scale has sufficient psychometric properties to enable recommendation as a preferred tool for measuring sitting balance with stroke survivors.

• Use of a balance scale or dedicated sitting balance measure containing static and dynamic sitting items should be utilised to monitor progress for individuals following stroke with more severe deficits.

     

Content and psychometric evaluations of questionnaires for assessing physical function in people with neck disorders: a systematic review of the literature

Purpose: The purpose was to investigate how physical function is assessed in people with musculoskeletal disorders (MSD) in the neck. Specifically, we aimed to determine: (1) Which questionnaires are used to assess physical function in people with MSD in the neck? (2) What do those questionnaires measure? (3) What are the measurement properties of the questionnaires?

Materials and methods: A systematic review was performed to identify questionnaires and psychometric evaluations. The content of the questionnaires was categorized according to the International Classification of Function, Disability and Health, and the psychometric properties were quality-rated using the COnsensus-based Standards for the selection of health Measurement INstruments checklist.

Results: Ten questionnaires and 32 articles evaluating measurement properties were analyzed. Most questionnaires covered only the components body functions and activity and participation, more often activity participation than body function. Internal consistency was adequate in most questionnaires, whereas responsiveness was generally low. Neck Disability Index was most evaluated, but the evaluations of all questionnaires tended to cover most properties in the checklist.

Conclusions: The questionnaires differed substantially in items and extent to which their psychometric properties had been evaluated. Focus of measurement was on activities in daily life rather than physical function as such.

• Implications for Rehabilitation

• To provide early diagnostics and effective treatment for patients with neck disorders, valid and reliable instruments that measure relevant aspects of the disorders are needed.

• This paper presents an overview of content and quality of questionnaires used to assess physical function in neck disorders, which may facilitate informed decisions about which measurement instruments to use when evaluating the course of neck disorders.

• Most of the questionnaires need more testing to judge the quality, however the NDI was the most frequently tested questionnaire.

• The COnsensus-based Standards for the selection of health Measurement INstruments checklist is a useful tool in relation to psychometric testing of questionnaires, but clear definitions of interpretation of the quality criteria in each study would enhance comparability of results.

     

Translation,cross-cultural adaptation,and psychometric properties of the Brazilian Portuguese version of the DiAbeTes Education Questionnaire (DATE-Q)

BackgroundThe DiAbeTes Education Questionnaire (DATE-Q) is a self-administered tool developed to evaluate disease-related knowledge and to assess knowledge of five core components of rehabilitation programs: physical exercise, diet, psychosocial well-being, disease self-management, and complications.ObjectiveTo translate and cross-culturally adapt into Brazilian Portuguese, and to test the psychometric properties of the DATE-Q for its use in Brazil.MethodsThe process of translation and cross-cultural adaptation consisted of five steps: translation into Brazilian Portuguese, synthesis of translation, back translation, expert committee, and pilot test of pre-final version. The pre-final version was applied to a sample of 30 patients with diabetes. Psychometric properties (internal consistency, reliability, construct validity, and ceiling and floor effects) of the final version of the Brazilian Portuguese version of the DATE-Q were tested in a sample of 200 adults with diabetes.ResultsThere was no conceptual divergence between the original and the translated versions. Ten (50%) items of the DATE-Q were culturally adapted. Internal consistency (Cronbach’s alpha coefficient = 0.6), reliability (intraclass correlation coefficient = 0.5), and construct validity (correlation between Diabetes Knowledge Scales and DATE-Q total scores: ρ = 0.7; P < 0.001) were confirmed. Ceiling or floor effects were not identified. The highest scoring item was about healthy eating. The average time for completion of the DATE-Q was 5 min and 51 s, and the completion rate was 100% for all items.ConclusionThe Brazilian Portuguese version of the DATE-Q showed adequate psychometric properties, and results suggested that the tool can be used to assess disease-related knowledge in adults with diabetes in Brazil.     

Cross-Cultural Translation and Adaptation to Brazilian Portuguese of the Paediatric Pain Profile in Children With Severe Cerebral Palsy

ContextPain is a prevalent symptom in children with severe cerebral palsy (CSCP), mainly as a result of the progression of muscle contractures, bone deformities, gastroesophageal reflux, and recurrent infections. Considering the lack of verbal communication in this population, both pain diagnosis and assessment of the analgesic treatment are often neglected. Although the Paediatric Pain Profile (PPP), an instrument with 20 items, is used to assess behavior indicative of pain in CSCP, it is not validated in Brazil.ObjectivesTo translate, adapt, and evaluate the psychometric properties of the PPP to Brazilian Portuguese.MethodsThe study was carried out at a philanthropic institution for CSCP and a university hospital. The sample of CSCP unable to communicate through speech or any device, their respective parents or primary caregivers, and health professionals were included. First, the instrument was translated and then back translated, and its clarity was evaluated by parents, primary caregivers, and professionals. The psychometric properties of the final version were evaluated for internal consistency (Cronbach's α) and stability (test-retest).ResultsForty-five children with a mean (SD) chronological age of 16 (8.69) years, 26 of whom were male, were included in the study. A total of 150 applications of PPP were carried out: 30 to assess clarity and 120 to assess the psychometric properties. Each item of the translated version showed a median between 3.00 and 4.00, considered to be clear and very clear, respectively. The internal consistency of the items was α = 0.864, with no significant difference between test and retest (P = 0.271).ConclusionThe adapted version of the PPP in Brazilian Portuguese demonstrated good internal consistency (similar to the original instrument) and stability over time, decisive for the next step of clinical validation for CSCP.     

Psychometric analysis of subjective sedation scales used for critically ill paediatric patients

Aims

This study evaluated the psychometric properties of subjective sedation scales using one psychometric scoring system to identify the appropriate scale that is most suitable for clinical care practice.

Background

A number of published sedation assessment scales for paediatric patients are currently used to attempt to achieve a moderate depth of sedation to avoid the undesirable effects caused by over‐ or undersedation. However, there has been no systematic review of these scales.

Search strategy

We searched the Cochrane Library, PubMed, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, etc., to obtain relevant articles. The quality of the selected studies was evaluated according to the Consensus‐based Standards for the Selection of Health Measurement Instruments checklist.

Inclusion criteria

Articles that had been published or were in press and discussed the psychometric properties of sedation scales were included. The population comprised critically ill infants and non‐verbal children ranging in age from 0 to 18 years who underwent sedation in an intensive care unit.

Findings

Data were independently extracted by two investigators using a standard data extraction checklist: 43 articles were included in this review, and 13 sedation scales were examined. The quality of the psychometric evidence for the Comfort Scale and Comfort Behaviour Scale was ‘very good’, with the Comfort Scale having a higher quality (total weighted scores, Comfort Scale = 17·3 and Comfort Behaviour Scale = 15·5).

Conclusions

We suggest that the scales be systematically and comprehensively tested in terms of development method, reliability, validation, feasibility and correlation with clinical outcome. The Comfort Scale and Comfort Behaviour Scale are useful tools for measuring sedation in paediatric patients.

Relevance to clinical practice

Nursing staff should choose one subjective sedation scale that is suitable for assessing paediatric patients' depth of sedation. We recommend the Comfort Scale and Comfort Behaviour Scale as optimal choices if the clinical environment permits.     

Electronic Patient-Reported Outcome Measures Evaluating Cancer Symptoms: A Systematic Review

ObjectivesThis systematic review aims to evaluate the psychometric properties and the methodologic quality of studies describing smartphone-, tablet- or computer-based questionnaires for Patient-Reported Outcome Measures (PROM) evaluating symptoms in oncology and hematology patients.Data SourcesA literature search was conducted in PubMed, Scopus, Cochrane, Cinahl, Cuiden, Lilacs, and PsycINFO. Criteria for inclusion were (i) primary studies evaluating scales for symptoms assessment, (ii) developed in adult population (>18 years) with an oncology or hematology malignancy diagnosis, (iii) validations tested via phone or computer, and (iv) describing at least one psychometric property. The exclusion criteria were (i) tools diagnosing any type of cancer and (ii) case series, surveys, and audits. The outcome variables were internal consistency, test-retest reliability, measurement error, content validity, structural validity, hypothesis testing, cross-cultural validity, and responsiveness. For the evaluation of the quality of methodology, the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used.ConclusionThe present study gathered five tools in 12 articles to evaluate cancer symptoms through smartphone, tablet, or computer format. Although four were generic, one was specific for breast cancer. Although none of the tools had been fully validated, some of the items of the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) were successfully tested for content, reliability, construct validity, and responsiveness.Implications for Nursing PracticeOur results can guide professionals choosing symptoms assessment instruments when performing telepractice, and they raise awareness of using with precaution scales not intended for remote use.     

Identification of Neonatal Infant Pain Assessment Tools as a Possibility of Their Application in Clinical Practice in Croatia: An Integrative Literature Review

ObjectivesThis article presents an integrative review of the literature with the aim of identifying instruments already in existence for measuring neonatal infant pain with a view to exploring possibilities of applying them in clinical practice in Croatia.DesignAn integrative review.Data sourcesThe databases searched included MEDLINE, Cinahl Cochrane Library, and Science Direct. The search was limited to available full-text articles in English published between 1990 and 2020. The studies were selected according to the PRISMA strategy and evaluated based on the methodologic framework proposed by Whittemore and Knafl.Review/Analysis methodsThe research identified 13 scales for assessing pain in neonatal infants, including 5 one-dimensional and 8 multidimensional scales that assess acute and prolonged pain in preterm and full-term infants.ResultsOverall, the articles in this review confirm that pain is a multidimensional phenomenon and that professionals should consider other specific characteristics of the neonatal infant population while measuring pain.ConclusionsOur review showed that various tools exist assessing pain in neonatal infants that could be used in clinical practice in Croatia. However, it is difficult to determine the most appropriate instrument at this stage, as the choice depends on various factors that still need to be considered. The decision on which pain scale to use or which is more appropriate should be based on further psychometric tests, its accuracy, and ease of use.     

The measurement properties of pediatric observational pain scales: A systematic review of reviews

BackgroundValid observational pain scales are needed to assess pain and ensure sufficient treatment of pain in children that lack the verbal ability to self-report pain. Published reviews attempt to synthesize results from primary studies validating these scales and based on the findings recommendations may be given, for example which pain scales are the most appropriate for use in different pediatric populations.ObjectivesThe aims of this review were to describe how systematic reviews have evaluated and recommended observational pain scales for use in children aged 0–18 years and appraise the evidence underlying these recommendations.DesignSystematic review of reviews.Data sourcesThe Cochrane Library, PubMed/MEDLINE, CINAHL, Web of Science, and PsychINFO were searched from inception to September 2016. Reference lists and gray literature were searched for additional studies.Review methodsStudy selection and data extraction were performed by two reviewers independently with a disagreement procedure in place. Methodological quality or study validity was measured using the Assessment of Multiple Systematic Reviews checklist and risk of bias or internal validity was measured using the Risk of Bias in Systematic Reviews tool. The review protocol was registered with PROSPERO: registration number CRD42016035264.ResultsTwelve reviews met the inclusion criteria. Together; they included 65 different observational pain scales for use in children, of which 28 were recommended at least once. Face, Legs, Activity, Cry, Consolability/revised version of Face, Legs, Activity, Cry, Consolability, COMFORT/COMFORT behavioral scale and Children’s Hospital of Eastern Ontario Pain Scale were evaluated and recommended most frequently. Few of the included reviews assessed the methodological quality of the studies included in the review. The narrative analysis consisted mostly of a reiteration of the results from the primary studies. In general, more recent reviews showed a lower risk of bias than older ones.ConclusionsIncluded reviews exhibited low quality of evidence; thus, their recommendations regarding pain scales for use in clinical practice or research with children that lack the verbal ability to self-report pain should be interpreted with caution.