Development of an observation method for assessing pain behaviors in children with juvenile rheumatoid arthritis

Objective. To develop an observation method for assessing pain behaviors in children with juvenile rheumatoid arthritis (JRA). Methods. Thirty children with JRA performed a standardized sequence of activities for video recording, and correlations between the pain behaviors observed on the videotapes and established measures of pain, depression, and functional disability were determined. Results. Pain behaviors were reliably observed (kappa coefficients 0.53‐0.79). Total pain behaviors were significantly correlated with subjective reports of pain (r = 0.50) and disability levels (r = 0.64). These behaviors were not significantly associated with children's depression ratings (r = 23). Conclusion. The results indicate that the behavioral observation method provides a reliable and valid measure of pain associated with JRA. Measurement of pain behaviors may be especially useful in treatment outcome studies because these behaviors are relatively independent of depression.