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J Pain. 2013 Mar;14(3):297-304. doi: 10.1016/j.jpain.2012.12.004. Epub 2013 Feb 4.

Is the verbal numerical rating scale a valid tool for assessing pain intensity in children below 8 years of age?

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Unit for the Study and Treatment of Pain - ALGOS, Centre de Recerca en Avaluació i Mesura de la Conducta, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain.


The verbal numerical rating scale (vNRS-11) is one of the most widely used scales for assessing pediatric pain intensity. The literature shows that it is a valid instrument for assessing pain intensity in children above 8 years of age. The aim of this work was to study whether the vNRS-11 is also a valid instrument when it is used with Catalan-speaking children between 6 and 8 years old. A total of 126 schoolchildren (mean age, 6.87; SD, .68) were interviewed individually. Participants reported the maximum intensity of the most frequent pain they had experienced in the previous 3 months, and the intensity they would experience in 3 circumstances, using the vNRS-11 and other widely used scales: the Faces Pain Scale-Revised (FPS-R), the mechanical visual analog scale (VAS), and the colored analog scale (CAS). They rated their affective state in relation to the pain experience and reported their pain-related disability. Participants also indicated which of the 4 scales they preferred. The vNRS-11 showed a high convergent construct validity (r = .73-.86), adequate discriminant validity (z = 2.05-5.55), and adequate criterion-related validity (r = .45-.70). The vNRS-11 was the second most preferred scale.


This study contributes to the increasing literature that supports the use of the vNRS-11 to assess pain intensity in children. Specifically, it shows that it can be used in children as young as 6 years of age.

[Indexed for MEDLINE]

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