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 .
Watch needle, watch TV: Audiovisual distraction in preschool immunization.
OBJECTIVE To evaluate the effectiveness of audiovisual distraction compared with a blank TV screen in the reduction of pain associated with intramuscular immunization . DESIGN Subjects were r and omly assigned to watch television ( TV ) ( N = 29 ) or a blank TV screen ( control ) ( N = 33 ) during immunization , and were videotaped . Immediately after the injection , the children rated their pain . Videotapes were coded for pain behaviors and for distraction . t tests determined between-group mean differences and chi-square tests compared proportions for clinical ly significant self-reported pain . SETTING Two urban pediatric practice s in Halifax , Nova Scotia , Canada . SUBJECTS Five-year-old children ( N = 62 ) , undergoing diphtheria , polio , tetanus , and pertussis immunization , and their parents . INTERVENTIONS An age-appropriate musical cartoon or a blank TV screen . OUTCOME MEASURES Pain measurements were the children 's self-reports on Faces Pain Scale , facial actions on Child Facial Coding System , and Children 's Hospital of Eastern Ontario Pain Scale . Distraction was measured by mean time spent watching the TV screen . Parents rated their own and their child 's anxiety on a visual analogue scale . RESULTS There were no significant group differences for any pain or distraction measures . The relative risk estimate for clinical ly significant pain among the distraction group was 0.64 ( range : 0.23 - 1.80 ) . Higher levels of distraction ( i.e. , greater time looking at the TV screen ) related to lower levels of pain on all three pain measures . Only correlations with objective pain measures were statistically significant . CONCLUSIONS Watching cartoons did not distract children during needle injection nor reduce their pain . Looking at the TV screen was related to lower behavioral pain scores in the total sample
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 .