Résumé
Une nouvelle échelle d’évaluation de la douleur de l’enfant de 2 à 6 ans, utilisant l’observation, a été élaborée dans une unité d’oncologie pédiatrique, à partir du recueil rétrospectif de descriptions d’enfants algiques. Des items d’atonie psychomotrice et d’anxiété ont été inclus dans l’échelle. L’échelle a été testée sur 80 enfants atteints de cancer, chaque enfant ayant été évalué par 2 infirmières et 2 auxiliaires de puériculture.
La sensibilité et la fiabilité se sont révélées satisfaisantes. L’Analyse Factorielle des Correspondances a montré que le 1er facteur (51% de la variance) était déterminé à la fois par des items de douleur et d’atonie psychomotrice. Un second facteur (13% de la variance) oppose des items de douleur aux items d’anxiété.
Ces résultats suggèrent que chez l’enfant de moins de 6 ans la douleur entraîne une atonie psychomotrice qui pourrait être proportionnelle à son intensité.
Summary
This study was designed to test a new rating observational scale for the diagnosis and grading of pain evoked by cancer in children of 2 to 6 years. We began by collecting retrospective clinical findings consisting of descriptions of children in pain. From these descriptions, an item scale was built up comprising overall patterns of behavior specific to pain. Because psychomotor atonia and anxiety items occured very frequently in the descriptions, they were included in the rating scale. The present preliminary report gives the results of the scale, which was tested in 80 children, chosen because they were liable to be in pain. Each child was evaluated by 2 nurses and 2 auxiliaries. Sensitivity and reproducibility were satisfactory. Factorial Correspondence Analysis showed that both psychomotor atonia and pain items contributed to the first axis, which accounted for 51% of the variance. A second axis was found, which contrasted anxiety and pain items, but it only accounted for 13% of the variance. These results suggest that in young children, pain evoked by severe disease leads to a depression-like reaction that correlates with that pain’s intensity.
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Gauvain-Piquard, A., Rodary, C., Rezvani, A. et al. La douleur chez l’enfant de 2 à 6 ans: mise au point d’une échelle d’évaluation utilisant l’observation du comportement. Doul. et Analg. 1, 127–133 (1988). https://doi.org/10.1007/BF03006308
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DOI: https://doi.org/10.1007/BF03006308