Pediatric Pain Behavior List [PPBL-47]

Description

The Pediatric Pain Behavior List (PPBL-47) is an instrument designed to record and assess behaviors associated with pain in children and adolescents, particularly in the context of postoperative pain. It focuses on observable and expressed pain-related behaviors and is intended to complement conventional pain assessment methods.

Behavioral assessment can be especially valuable when verbal self-report is limited or when a more comprehensive evaluation of a child’s pain experience is required.

Purpose

The main purpose of the PPBL-47 is to identify and document expressed pain behaviors in children, support the recording of pain reports, and examine the relationship between behavioral manifestations of pain and results obtained from traditional pain rating scales.

This approach allows pain to be assessed not only through verbal descriptions but also through observable behavioral indicators.

Structure

The PPBL-47 includes 47 pain-related behaviors, organized into seven main categories:

Body posture, limbs, touch, facial expression, tone of voice, verbal response, and emotional response.

This structure provides a broad representation of the ways in which children may express pain following a surgical procedure.

Scoring

According to the source material, children and their parents are asked to respond to 47 questions. Pain intensity is classified using the following ranges:

0 = No pain
1–3 = Mild pain
4–6 = Moderate pain
7–10 = Severe pain

Higher scores indicate higher levels of pain.

Validity

The source material emphasizes that behavioral responses and spontaneous reactions to pain may provide important indicators of the child’s pain experience. These reactions can emerge as immediate responses to intense or persistent painful stimuli.

The relationship of these behaviors with other variables and with alternative pain assessment methods is presented as supporting the construct validity of the behavioral list.

Applications

The PPBL-47 may be used in pediatric care, postoperative settings, clinical research, and studies investigating the expression and assessment of pain in children and adolescents.

Systematic observation of pain-related behaviors may also support monitoring over time and comparison of pain levels before and after pain-management interventions.

References

Moline, R. L., McMurtry, C. M., Noel, M., McGrath, P. J., & Chambers, C. T. (2021). Parent–child interactions during pediatric venipuncture: Investigating the role of parent traits, beliefs, and behaviors in relation to child outcomes. Canadian Journal of Pain, 5(1), 151–165.

Xiong, T., Kaltenbach, E., Yakovenko, I., Lebsack, J., & McGrath, P. J. (2022). How to measure barriers in accessing mental healthcare? Psychometric evaluation of a screening tool in parents of children with intellectual and developmental disabilities.