Wong Baker Faces Pain Rating Scale Extra Quality Free Download

Objectives: The Wong-Baker FACES Pain Rating Scale (WBS), used in children to rate pain severity, has been validated outside the emergency department (ED), mostly for chronic pain. The authors validated the WBS in children presenting to the ED with pain by identifying a corresponding mean value of the visual analog scale (VAS) for each face of the WBS and determined the relationship between the WBS and VAS. The hypothesis was that the pain severity ratings on the WBS would be highly correlated (Spearman's rho > 0.80) with those on a VAS.

Methods: This was a prospective, observational study of children ages 8-17 years with pain presenting to a suburban, academic pediatric ED. Children rated their pain severity on a six-item ordinal faces scale (WBS) from none to worst and a 100-mm VAS from least to most. Analysis of variance (ANOVA) was used to compare mean VAS scores across the six ordinal categories. Spearman's correlation (rho) was used to measure agreement between the continuous and ordinal scales.

Wong Baker Faces Pain Rating Scale Free Download

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There are 6 faces in the Wong-Baker Pain Scale. The first face represents a pain score of 0, and indicates "no hurt". The second face represents a pain score of 2, and indicates "hurts a little bit". The third face represents a pain score of 4, and indicates "hurts a little more". The fourth face represents a pain score of 6, and indicates "hurts even more". The fifth face represents a pain score of 8, and indicates "hurts a whole lot"; the sixth face represents a pain score of 10, and indicates "hurts worst".[2]

With the assistance of Peggy Cook, the hospital librarian, Connie and Donna learned everything they could about pain assessment and management. Through a thorough literature review, they eventually uncovered a few scales used with adults and some tools developed for children. Adapting a few of the adult scales and using the existing pediatric tools, Connie and Donna began introducing new assessment tools to patients.

Initially, the faces received numeric ratings from 0-5, with 0 for no pain and 1 to 5 for increasing intensities of pain. It was essential to find the right balance between too many and not enough faces. Six choices were consistent with other scales used, which facilitated statistical comparison among the scales.

To determine if children could use the scale to distinguish between different pain intensities, Connie asked children to mark their areas of pain on a drawing of a human figure then rate each area using the faces scale. Many of the children were burned on parts of the body more likely to be painful than others. This round of discovery showed that children quite accurately assessed pain intensity.

Data was gathered at Hillcrest Medical Center and St. Francis Hospital in Tulsa, as well as the University of California Davis Medical Center in Sacramento, where Connie later worked as a child life specialist. The FACES Scale was assessed along with an adaptation of the visual analog scale, and 4 other pain assessment instruments.

Most of the research subjects were children from preschool through young school-age (9-10 years of age). Because teenagers could use any of the adult scales, few adolescent subjects were invited to participate in the early work. It was thought that the idea of using faces to rate pain might seem too juvenile to adolescents

The primary goal for creating the Wong-Baker FACES Pain Rating Scale was to help children effectively communicate about their pain so staff and parents could more successfully manage their pain. Initially, the numbers 0-5 were used to quantify the pain, but using the numbers 0-2-4-6-8-10 avoids confusion as it is more consistent with the numeric rating scale of 0-10.

Another Wong-Baker FACES Foundation board member, Pam DiVito-Thomas, PhD, RN, CNE and Dr. Donna Wong spent 5 years on an international and longitudinal study on three continents. That data was collated, but never written. We believed the data had been lost, until recently, when Dr. DiVito-Thomas found it on a flash drive! In 2003, former board member, Dr. Kristie Nix, joined with Dr. Donna Wong to research the use of the pain scale with adults.

In 2009, Connie Baker began the Wong-Baker FACES Foundation to continue the work of protecting the integrity of the scale, as well as promoting excellence in pain care. The Wong-Baker FACES Pain Rating Scale has a registered copyright and trademark. People from nearly all countries in the world have visited this website. The scale is translated into over 60 languages, and the list is growing.

The FACES Scale was created with children for children and it remains widely used. The scale is supported by years of research, and it continues to be used in study around the world. However, time shows that the scale is valid for use with people of ages three and older, not limited to children. Other investigators have used the faces scale with adults, especially the elderly, with successful results. The cartoon-type faces scale avoids gender, age, and racial biases.

Using faces, numbers, and short phrases helps provide multiple ways for someone to understand what level of pain they may be experiencing. Subsequently, this allows them to communicate this to a healthcare professional. This may allow them to perform the necessary actions to help ease any discomfort the individual may be experiencing.

Donnie Wong and Connie Baker developed The Wong-Baker Faces Pain Rating Scale in 1983. Their research identified that children had difficulty rating their pain with numbers yet responded well to facial expressions. Consequently, they developed the scale to help children better communicate their pain.

The scale starts at 0 and ends at 10, with the numbers increasing in intervals of 2. Each number relates to both a face and a small descriptive phrase. It is flexible because if someone uses the numbers, they may not need the faces or the wording.

However. since its development, researchers have identified that the scale is suitable for adults. For example, a 2018 study used the scale to measure pain levels for people attending the emergency department with extremity traumas.

A healthcare professional will ask people to rate their pain by considering the faces, numbers, and descriptions. Ideally, a healthcare professional would introduce the scale when a person is not experiencing pain, for example, before an operation. However, this may not be possible in emergencies.

Firstly, a 2021 study suggests that the scale is less effective than other pain measurement methods, such as the Functional Pain Scale. The Functional Pain scale assesses pain by associating numbers with functional impairments. This provides a more objective indicator to help assess pain.

Secondly, children may find the scale confusing, where regardless of pain, their face might not reflect the face on the scale. They may interpret the expressions rather than see them as a means to describe their physical pain.

The use of validated pain assessment tools is an integral part of the assessment and treatment of patients with acute pain. Prehospital healthcare protocols or guidelines should include specific validated tools based upon the patient type to include age and ability to communicate.[15] There are several different pain scales based upon age that ranges from preterm to adulthood. Srouji et al. have listed over 20 different pain scales for preterm to 18 years of age.[11] Additional scales include those for the non-verbal patients as well as those with dementia. The measurement of pain and pain intensity can be performed by several methods: behavioral, physiological measures, and self-reporting. The most widely used pain assessment scales utilize the self-reporting method, which has the most valid and optimal measurements, but these scales are limited in the pediatric population because of the cognitive and language development of children and lack of the younger child's ability to describe the pain.[11] These scales also have limited utility for the non-verbal patient because of the inability to vocalize. Pain assessment for the younger patient, as well as the non-verbal patient, is then based upon the behavioral and physiological measurements. Body posture and movements, crying, and facial expressions are examples of behavioral measures. Physiological measures would include key vital signs of heart rate, blood pressure, respiration, and oxygen saturation, as well as palmer sweating and other neuroendocrine responses.[11] Some popular tools include:

Each category (Face, Legs etc) is scored on a 0-2 scale, which results in a total pain score between 0 and 10. The person assessing the child should observe them briefly and then score each category according to the description supplied.

FLACC has a high degree of usefulness for cognitively impaired and many critically ill children

The Faces Pain Scale is a self-report measure used to assess the intensity of children's pain. It is generally accepted that the measurement of pain in children, by healthcare professionals, is a difficult task. This is due to the children's varying levels of language, communication, and development, and the way in which they express pain, compared to an adult. [1] One way of measuring pain in Children is by using scales of various facial expressions, and associating their pain level to a similar face.

The purpose of this scale is to impose a reduced cognitive burden on children, and thus it is designed for very young children. It is assumed that children are capable of recognizing facial expressions rather than verbal or numerical ratings (as on other pain scales). It is noted that by the age of 4 and 5, children have the capability to identify and distinguish various facial features and facial patterns of different general emotions. [1]

Wen used on children in the Emergency Department at the Hospital, the most common selected Face was the 'hurts even more', which is associated with a Visual Analog Scale (VAS) score of 55. One-fifth of a study population of children in the emergency department reported a VAS score of 80. However, many of these children did not select the 'worst hurt' face. It is seen that identifying the faces on the Wong-Baker Faces Pain Scale are emotionally driven, which may be misidentified as non-painful emotions, and thus may skew severity reporting. [2] e24fc04721