Brief Description

The PPBL is a comprehensive observational checklist of behaviors associated with children’s and adolescents’ responses to postoperative pain. It includes 47 behaviors (such as refusal to eat, whining, motor restlessness, verbal pain expression, etc.) that are observed and rated by healthcare professionals, primarily nurses. The scale is grounded in systematic behavioral observation of children following surgery and is supported by both theoretical and empirical evidence.

Purpose

The assessment of children’s and adolescents’ behavior in response to postoperative pain aims to shed light on the biological and behavioral underpinnings of the pain experience. The purpose of the questionnaire is to evaluate pain expression through observable behaviors and to measure pain intensity, thereby assisting in determining the need for analgesia and enhancing the understanding of the psychological and physiological aspects of pain.

Scoring Method

Each behavior is evaluated individually for clarity, reliability, and distinction from other behaviors. The evaluation is recorded as either presence or absence of the behavior. Inter-rater agreement rates were recorded as 100%. Data analyses include means, standard deviations, ranges, and T-values.

Validity

The observed and recorded behaviors are considered valid indicators of pain, demonstrating adequate construct validity. The tool’s validity is further supported by its correlation with other pain measures such as the McGrath scale, CHEOPS, and CHOP-R.

Reliability

Reliability is primarily assessed through inter-rater agreement, which reaches 100% for individual behaviors. Additional support for the tool’s reliability comes from correlations between PPBL behaviors and other validated pain assessment tools and observational scales.

Data Analysis and Application

Data were analyzed using descriptive statistics (means, standard deviations, T-values). Interpretation focuses on the frequency and severity of behaviors. These behaviors are correlated with clinical data and contribute to the evaluation of pain, prognosis, and the enhancement of care quality provided to pediatric patients.

References

Hatira, P., & Matziou, V. (2001). Children’s Behavior Postoperative Pain. 2nd World Congress of World Institute of Pain, Istanbul, Turkey (poster presentation).
Hatira, P., & Matziou, V. (under editorial review). Children’s Behavior Postoperative Pain.
McGrath, P., Unruh, A., & Finley, G. (1995). Pain Measurement in Children. Pain Clinical Update, ISAP, III(2), 1–4.
Tesler, D. M., Holzemer, W. L., & Saavedra, C. M. (1998). Pain Behaviors: Postsurgical Responses of Children and Adolescents. Journal of Pediatric Nursing, 13(1), 41–47.