Verifying the validity and reliability of the Japanese version of the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale
Pediatric patients, especially in the preverbal stage, cannot self-report intensity of pain therefore several validated observational tools, including the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale, have been used as a benchmark to evaluate pediatric pain. Unfortunately, this...
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| description | Pediatric patients, especially in the preverbal stage, cannot self-report intensity of pain therefore several validated observational tools, including the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale, have been used as a benchmark to evaluate pediatric pain. Unfortunately, this scale is currently unavailable in Japanese, precluding its widespread use in Japanese hospitals.
To translate and verify the validity and reliability of the Japanese version of the FLACC Behavioral Scale.
Back-translation was first conducted by eight medical researchers, then an available sample of patients at the University of Tsukuba Pediatric Intensive Care Unit (from May 2017 to August 2017) was enrolled in a clinical study. Two researchers evaluated the validity of the translated FLACC Behavioral Scale by weighted kappa coefficient and intraclass correlation coefficients (ICC). Observational pain was simultaneously measured by the visual analog scale (VAS obs) and reliability was evaluated by correlation analysis.
The original author approved the translation. For the clinical study, a total of 121 observations were obtained from 24 pediatric patients. Agreement between observers was highly correlated for each of the FLACC categories (Face: κ = 0.85, Leg: κ = 0.74, Activity: κ = 0.89, Cry: κ = 0.93, Consolability: κ = 0.93) as well as the total score (Total: κ = 0.95,). Correlation analysis demonstrated a good criterion validation between the FLACC scale and the VAS obs. (r = 0.96).
Our Japanese version of the FLACC Behavioral Scale shows high validity and reliability. |
| doi_str_mv | 10.1371/journal.pone.0194094 |
| format | Article |
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To translate and verify the validity and reliability of the Japanese version of the FLACC Behavioral Scale.
Back-translation was first conducted by eight medical researchers, then an available sample of patients at the University of Tsukuba Pediatric Intensive Care Unit (from May 2017 to August 2017) was enrolled in a clinical study. Two researchers evaluated the validity of the translated FLACC Behavioral Scale by weighted kappa coefficient and intraclass correlation coefficients (ICC). Observational pain was simultaneously measured by the visual analog scale (VAS obs) and reliability was evaluated by correlation analysis.
The original author approved the translation. For the clinical study, a total of 121 observations were obtained from 24 pediatric patients. Agreement between observers was highly correlated for each of the FLACC categories (Face: κ = 0.85, Leg: κ = 0.74, Activity: κ = 0.89, Cry: κ = 0.93, Consolability: κ = 0.93) as well as the total score (Total: κ = 0.95,). Correlation analysis demonstrated a good criterion validation between the FLACC scale and the VAS obs. (r = 0.96).
Our Japanese version of the FLACC Behavioral Scale shows high validity and reliability.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0194094</identifier><identifier>PMID: 29534083</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Asthma ; Behavior Rating Scale - standards ; Behavior rating scales ; Biology and Life Sciences ; Child ; Child, Preschool ; Correlation ; Correlation analysis ; Correlation coefficient ; Correlation coefficients ; Critical care ; Delirium ; Evaluation ; Face ; Facial Expression ; Female ; Health status indicators ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Intensive care ; Intensive Care Units, Pediatric ; Japan ; Leg ; Legs ; Male ; Medical care quality ; Medical protocols ; Medical research ; Medicine ; Medicine and Health Sciences ; Methods ; Mortality ; Nociception ; Nurses ; Pain ; Pain Measurement - methods ; Pain Measurement - standards ; Patients ; Pediatrics ; People and Places ; Preschool children ; Psychometrics - methods ; Reliability analysis ; Reproducibility of Results ; Research and Analysis Methods ; Researchers ; Studies ; Testing ; Translating ; Translation ; Translations ; Translations and translating ; Validity ; Ventilators ; Visual observation</subject><ispartof>PloS one, 2018-03, Vol.13 (3), p.e0194094-e0194094</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Matsuishi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Matsuishi et al 2018 Matsuishi et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c703t-6b65b8364060cc957389cfa1d900a32f7bc178e8066f6a6783f0cf423ae914c53</citedby><cites>FETCH-LOGICAL-c703t-6b65b8364060cc957389cfa1d900a32f7bc178e8066f6a6783f0cf423ae914c53</cites><orcidid>0000-0001-6388-9263</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849287/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849287/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29534083$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Matsuishi, Yujiro</creatorcontrib><creatorcontrib>Hoshino, Haruhiko</creatorcontrib><creatorcontrib>Shimojo, Nobutake</creatorcontrib><creatorcontrib>Enomoto, Yuki</creatorcontrib><creatorcontrib>Kido, Takahiro</creatorcontrib><creatorcontrib>Hoshino, Tetsuya</creatorcontrib><creatorcontrib>Sumitani, Masahiko</creatorcontrib><creatorcontrib>Inoue, Yoshiaki</creatorcontrib><title>Verifying the validity and reliability of the Japanese version of the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Pediatric patients, especially in the preverbal stage, cannot self-report intensity of pain therefore several validated observational tools, including the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale, have been used as a benchmark to evaluate pediatric pain. Unfortunately, this scale is currently unavailable in Japanese, precluding its widespread use in Japanese hospitals.
To translate and verify the validity and reliability of the Japanese version of the FLACC Behavioral Scale.
Back-translation was first conducted by eight medical researchers, then an available sample of patients at the University of Tsukuba Pediatric Intensive Care Unit (from May 2017 to August 2017) was enrolled in a clinical study. Two researchers evaluated the validity of the translated FLACC Behavioral Scale by weighted kappa coefficient and intraclass correlation coefficients (ICC). Observational pain was simultaneously measured by the visual analog scale (VAS obs) and reliability was evaluated by correlation analysis.
The original author approved the translation. For the clinical study, a total of 121 observations were obtained from 24 pediatric patients. Agreement between observers was highly correlated for each of the FLACC categories (Face: κ = 0.85, Leg: κ = 0.74, Activity: κ = 0.89, Cry: κ = 0.93, Consolability: κ = 0.93) as well as the total score (Total: κ = 0.95,). Correlation analysis demonstrated a good criterion validation between the FLACC scale and the VAS obs. (r = 0.96).
Our Japanese version of the FLACC Behavioral Scale shows high validity and reliability.</description><subject>Asthma</subject><subject>Behavior Rating Scale - standards</subject><subject>Behavior rating scales</subject><subject>Biology and Life Sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Correlation</subject><subject>Correlation analysis</subject><subject>Correlation coefficient</subject><subject>Correlation coefficients</subject><subject>Critical care</subject><subject>Delirium</subject><subject>Evaluation</subject><subject>Face</subject><subject>Facial Expression</subject><subject>Female</subject><subject>Health status indicators</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Intensive care</subject><subject>Intensive Care Units, Pediatric</subject><subject>Japan</subject><subject>Leg</subject><subject>Legs</subject><subject>Male</subject><subject>Medical care quality</subject><subject>Medical protocols</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Mortality</subject><subject>Nociception</subject><subject>Nurses</subject><subject>Pain</subject><subject>Pain Measurement - methods</subject><subject>Pain Measurement - standards</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>People and Places</subject><subject>Preschool children</subject><subject>Psychometrics - methods</subject><subject>Reliability analysis</subject><subject>Reproducibility of Results</subject><subject>Research and Analysis Methods</subject><subject>Researchers</subject><subject>Studies</subject><subject>Testing</subject><subject>Translating</subject><subject>Translation</subject><subject>Translations</subject><subject>Translations and translating</subject><subject>Validity</subject><subject>Ventilators</subject><subject>Visual observation</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNptUl2PEyEUnRiNu67-A6OT-LImbYVhYODFpDZbXdPEBz9eCcNcWho6VJg26S_wby-znW62ZiHh43LOgXs5WfYWowkmFf609rvQKjfZ-hYmCIsSifJZdokFKcasQOT5o_VF9irGNUKUcMZeZheFoKREnFxm__5AsOZg22XerSDfK2cb2x1y1TZ5AGdVbV2_9-b-_LvaqhZiAkKI1ren-FxpGOULWMZRPtWd3SfOKJ-FfvBt9O6kcz1fTGezj_kXWKm99UG5_KdWDl5nL4xyEd4M81X2e37za_ZtvPjx9XY2XYx1hUg3ZjWjNSesRAxpLWhFuNBG4UYgpEhhqlrjigNHjBmmWMWJQdqUBVEgcKkpucreH3W3zkc51DDKAmHCUN8S4vaIaLxay22wGxUO0isr7wM-LKUKndUOJMWCAgVTkIaUCkjdGMV4jUVtdI10nbQ-D7ft6g00GtouZXwmen7S2pVc-r2kvBQFr5LA9SAQ_N8dxE5ubNTgXPoFvzu-u-Il5TxBP_wHfTq7AbVMRZe2NT7dq3tROaUE8QpjhhNq8gQq9QY2VifDGZviZ4TySNDBxxjAPOSIkeztenqM7O0qB7sm2rvH9XkgnfxJ7gC0pube</recordid><startdate>20180313</startdate><enddate>20180313</enddate><creator>Matsuishi, Yujiro</creator><creator>Hoshino, Haruhiko</creator><creator>Shimojo, Nobutake</creator><creator>Enomoto, Yuki</creator><creator>Kido, Takahiro</creator><creator>Hoshino, Tetsuya</creator><creator>Sumitani, Masahiko</creator><creator>Inoue, Yoshiaki</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6388-9263</orcidid></search><sort><creationdate>20180313</creationdate><title>Verifying the validity and reliability of the Japanese version of the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale</title><author>Matsuishi, Yujiro ; Hoshino, Haruhiko ; Shimojo, Nobutake ; Enomoto, Yuki ; Kido, Takahiro ; Hoshino, Tetsuya ; Sumitani, Masahiko ; Inoue, Yoshiaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c703t-6b65b8364060cc957389cfa1d900a32f7bc178e8066f6a6783f0cf423ae914c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Asthma</topic><topic>Behavior Rating Scale - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matsuishi, Yujiro</au><au>Hoshino, Haruhiko</au><au>Shimojo, Nobutake</au><au>Enomoto, Yuki</au><au>Kido, Takahiro</au><au>Hoshino, Tetsuya</au><au>Sumitani, Masahiko</au><au>Inoue, Yoshiaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Verifying the validity and reliability of the Japanese version of the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-03-13</date><risdate>2018</risdate><volume>13</volume><issue>3</issue><spage>e0194094</spage><epage>e0194094</epage><pages>e0194094-e0194094</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Pediatric patients, especially in the preverbal stage, cannot self-report intensity of pain therefore several validated observational tools, including the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale, have been used as a benchmark to evaluate pediatric pain. Unfortunately, this scale is currently unavailable in Japanese, precluding its widespread use in Japanese hospitals.
To translate and verify the validity and reliability of the Japanese version of the FLACC Behavioral Scale.
Back-translation was first conducted by eight medical researchers, then an available sample of patients at the University of Tsukuba Pediatric Intensive Care Unit (from May 2017 to August 2017) was enrolled in a clinical study. Two researchers evaluated the validity of the translated FLACC Behavioral Scale by weighted kappa coefficient and intraclass correlation coefficients (ICC). Observational pain was simultaneously measured by the visual analog scale (VAS obs) and reliability was evaluated by correlation analysis.
The original author approved the translation. For the clinical study, a total of 121 observations were obtained from 24 pediatric patients. Agreement between observers was highly correlated for each of the FLACC categories (Face: κ = 0.85, Leg: κ = 0.74, Activity: κ = 0.89, Cry: κ = 0.93, Consolability: κ = 0.93) as well as the total score (Total: κ = 0.95,). Correlation analysis demonstrated a good criterion validation between the FLACC scale and the VAS obs. (r = 0.96).
Our Japanese version of the FLACC Behavioral Scale shows high validity and reliability.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29534083</pmid><doi>10.1371/journal.pone.0194094</doi><orcidid>https://orcid.org/0000-0001-6388-9263</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Asthma Behavior Rating Scale - standards Behavior rating scales Biology and Life Sciences Child Child, Preschool Correlation Correlation analysis Correlation coefficient Correlation coefficients Critical care Delirium Evaluation Face Facial Expression Female Health status indicators Hospitals Humans Infant Infant, Newborn Intensive care Intensive Care Units, Pediatric Japan Leg Legs Male Medical care quality Medical protocols Medical research Medicine Medicine and Health Sciences Methods Mortality Nociception Nurses Pain Pain Measurement - methods Pain Measurement - standards Patients Pediatrics People and Places Preschool children Psychometrics - methods Reliability analysis Reproducibility of Results Research and Analysis Methods Researchers Studies Testing Translating Translation Translations Translations and translating Validity Ventilators Visual observation |
| title | Verifying the validity and reliability of the Japanese version of the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-02T17%3A54%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Verifying%20the%20validity%20and%20reliability%20of%20the%20Japanese%20version%20of%20the%20Face,%20Legs,%20Activity,%20Cry,%20Consolability%20(FLACC)%20Behavioral%20Scale&rft.jtitle=PloS%20one&rft.au=Matsuishi,%20Yujiro&rft.date=2018-03-13&rft.volume=13&rft.issue=3&rft.spage=e0194094&rft.epage=e0194094&rft.pages=e0194094-e0194094&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0194094&rft_dat=%3Cgale_plos_%3EA530871161%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2013600000&rft_id=info:pmid/29534083&rft_galeid=A530871161&rft_doaj_id=oai_doaj_org_article_5195e5ef23d34ae3bdfa68b19bfcb0cb&rfr_iscdi=true |