For example, Stinson et al 8 excluded the NRS-11 from their review on self-report pediatric pain intensity measures because they found it had not yet been adequately evaluated in research. This inconsistency was highlighted by several authors who encouraged clinicians and researchers to work to address this limitation. However, until recently, there has been very limited research on the psychometric properties of the NRS-11 for use in children and adolescents with acute or chronic pain. 4,5 Moreover, NRSs seem to be preferred over other pain intensity measures by most of the patients in different populations and cultures, 6 for example, when compared with other pain intensity scales such as the Verbal Descriptor Scale or the Visual Analog Scale (VAS). 1 Research provides support for the validity of self-reported NRS-11 pain intensity scores through their positive and significant correlations with other measures of pain intensity 2,3 and responsivity to treatments aimed at diminishing or eliminating pain. The NRS-11 has been extensively studied in research with adults. A number of self-report measures of pain intensity have been developed to be used with children and adolescents, and the 0 to 10 Numerical Rating Scale ( NRS-11) is among the most commonly used measures in this context. Although the multidimensional nature of the pain experience is well recognized in children and adolescents, pain intensity is the preferred pain-related domain when it comes to making pain management decisions (e.g., increasing or decreasing a drug dose) or deciding whether a treatment has been successful. Valid and reliable pain assessment is a basic requirement for effective clinical care of youths with acute and chronic pain. On the basis of available information, the NRS-11 can be considered to be a well-established measure for use with pediatric populations. Discussion:Īdditional research is needed to clarify some unresolved questions and issues, including (1) the minimum age that children should have to offer valid scores of pain intensity and (2) the development of consensus regarding administration instructions, in particular with respect to the descriptors used for the upper anchor. The findings of reviewed studies support the reliability and validity of the NRS-11 when used with children and adolescents. Results:Ī total of 382 articles were retrieved, 301 were screened for evaluation, and 16 were included in the review. Methods:Ī literature search was conducted using PubMed, PsycINFO, CINAHL, and the Psychology and Behavioral Sciences Collection from their inception to February 2016. The purpose of this study was to review this research and summarize what is known regarding the reliability and validity of the NRS-11 as a self-report measure of pediatric pain intensity. Recently, there has been an increase in published findings regarding the strengths and weaknesses of the NRS-11 as a measure of pain in youths. The Numerical Rating Scale-11 ( NRS-11) is one of the most widely used scales to assess self-reported pain intensity in children, despite the limited information on its psychometric properties for assessing pain in pediatric populations. The work cannot be changed in any way or used commercially. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. Reprints: Jordi Miró, PhD, Departament de Psicologia, Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007 Tarragona, Catalonia, Spain (e-mail: ). The authors declare no conflict of interest. J.M.’s work is supported by the Institució Catalana de Recerca i Estudis Avançats (ICREA-Acadèmia) and Fundación Grünenthal, Catalonia, Spain. work is supported by grant PSI2014-60180-JIN of the Spanish Ministry of Economy and Competitiveness, Catalonia, Spain. Supported in part, by Obra Social de Caixabank, the Spanish Ministry of Economy and Competitiveness (grants PSI2012-32471 and PSI2015-70966-P), Catalonia, Spain, and Universitat Rovira i Virgili (PFR program), Catalonia, Spain. ♯aculty of Medicine, University of Manitoba, Winnipeg, MB, Canada ∥Departments of Psychology and Pediatrics, University of Saskatchewan, Saskatoon, SK §Department of Rehabilitation Medicine, University of Washington, Seattle, WA #Chair in Pediatric Pain URV-Fundación Grünenthal, Universitat Rovira i Virgili, Catalonia, Spain ‡Institut d’Investigació Sanitària Pere Virgili †Department of Psychology, Research Center for Behavior Assessment (CRAMC) *Unit for the Study and Treatment of Pain-ALGOS
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