Investigating the Assessment Tools for Pain Severity During Venipuncture in Preschool-age Children: A Systematic Review

Background: Improper use of standards for measurement instruments can impact the accuracy of study results. Objectives: This study systematically reviews the Instruments for measuring pain intensity during venous catheter insertion in preschool children. Methods: In this systematic review, conducted from October 2023 to January 2023, an open search was carried out for articles in domestic databases, such as scientific information database (SID), MagIran, and Iran Medex, and international databases, including PubMed, CINAHL, Web of Science, and Scopus using the following keywords: Preschool period, pain intensity, cannulation, vein removal, pain scale, pain relief, pain perception, and pain sensation. The objective of this search was to examine the measurement tools utilized to assess pain intensity during venipuncture in preschool-aged children without a time restriction. Duplicate articles were excluded, and other studies meeting the inclusion criteria were reviewed. Articles were assessed by two researchers, and any discrepancies were resolved by a third author. Results: Among all the reviewed studies, 21 articles that were conducted between 2001 and 2023 met the inclusion criteria. The tools utilized in these studies to assess pain intensity during venous catheter insertion in preschool children included face, legs, activity, cry, and consolability (FLACC), Wong-Baker, Oucher scale, visual analog scale, and Poker Chip scale. The Wong-Baker instrument was a self-assessment, FLACC were assessed by both the researcher and a reviewer, Oucher was a self-assessment, the visual analog scale was assessed by parents and reviewers, and the Poker Chip scale was a self-assessment. Conclusions: Researchers who do not adhere to tool standards often opt to utilize tools based on the methods of other studies or their requirements, which could potentially impact the outcomes of their studies