All 4 faces pain scales were found to be adequately supported by psychometric data .
When given a choice between faces scales , children preferred the WBFPRS .
Confounding of pain intensity with affect caused by use of smiling and crying anchor faces is a disadvantage of the WBFPRS .
: For clinical use , we found no grounds to switch from 1 faces scale to another when 1 of the scales is in use .
CONTEXT : Numerous faces scales have been developed for the measurement of  pain intensity in children .
It remains unclear whether any one of the faces scales is better for a particular purpose with regard to validity , reliability , feasibility , and preference .
OBJECTIVES : To summarize and systematic ally review faces pain scales most commonly used to obtain self-report of pain intensity in children for evaluation of reliability and validity and to compare the scales for preference and utility .
[Better postoperative pain management in children by introduction of guidelines; a prospective study].
OBJECTIVE To investigate the influence of recommendations on the quality of postoperative pain management in children . DESIGN Prospect i ve . SETTING University Hospital Groningen , the Netherl and s. METHOD After interdisciplinary recommendations on postoperative pain were developed , the quality of postoperative pain management was investigated before implementation ( phase I ; n = 50 children aged 0 - 14 who underwent elective surgery ) , three months after the implementation ( phase II ; n = 51 ) , and nine months later ( phase III ; n = 50 ) . Quality was defined by a pain score ( for ages 0 to 4 with the ' Children 's Hospital of Eastern Ontario pain scale ' ( CHEOPS ) and for ages 4 - 14 with the Oucher scale ) and the prescription of analgetics : kind , dose , frequency , prescription by anaesthetist and doctor on the ward . Pain was scored every 2 hours during the first 24 hours after surgery . A CHEOPS score < or = 6 an Oucher score < or = 50 was defined as adequate ; higher scores were defined as inadequate . RESULTS Pain measurement showed a statistically significant improvement of pain scores in time ( phase II and III compared with phase I : odds ratio : 2.5 ; 95 % confidence interval : 1.03 - 6.00 ; p < 0.01 ) . Search ing for factors that could be responsible for this improvement , like medication , we found no statistically significant differences in everyday practice in phase II and III compared with phase I. However , children who could score their pain by self-report ( Oucher ) showed the best results in all 3 phases of the study . The youngest children , i.e. less than 6 months old , showed inadequate results during the whole study . The greatest improvement in time during the first 12 hours was seen in the group of children older than 6 months . The recommendations were followed more strictly in younger children , and when continuous morphine was given . CONCLUSION Pain scores in children  improved after the introduction of recommendations on postoperative pain . However , the improvement could not be attributed to factors like medication . Factors like a change in attitude towards pain could be responsible for this change
All 4 faces pain scales were found to be adequately supported by psychometric data .
When given a choice between faces scales , children preferred the WBFPRS .
Confounding of pain intensity with affect caused by use of smiling and crying anchor faces is a disadvantage of the WBFPRS .
: For clinical use , we found no grounds to switch from 1 faces scale to another when 1 of the scales is in use .
CONTEXT : Numerous faces scales have been developed for the measurement of  pain intensity in children .
It remains unclear whether any one of the faces scales is better for a particular purpose with regard to validity , reliability , feasibility , and preference .
OBJECTIVES : To summarize and systematic ally review faces pain scales most commonly used to obtain self-report of pain intensity in children for evaluation of reliability and validity and to compare the scales for preference and utility .