[Validation of the Spanish version of Parent's Postoperative Pain Management pain scale]. / Validación de la versión española de la escala de evaluación del dolor postoperatorio Parent's Postoperative Pain Managament.

INTRODUCTION: Assessment of postoperative pain is a fundamental aspect of post-surgical care. When surgery is performed as an outpatient, the parents are mainly responsible for the assessment of pain, but they may not always correctly evaluate their children's pain. This makes it necessary to have tools that help them to assess postoperative pain reliably. The Parent's Postoperative Pain Measurement (PPPM) is a behavioral measurement tool of post-operative pain developed to help parents to assess their children's post-operative pain. The purpose of this work was to translate this scale into Spanish, and validate the psychometric properties of the Spanish version of the scale. METHOD: Participants were 111 children aged 2 to 12 years, who had undergone surgery, and one of their parents. After the operation, the children's level of pain was assessed, and the parents completed the PPPM scale in Spanish. RESULTS: The PPPM items in Spanish showed good internal consistency (Cronbach alpha between 0.784 and 0.900) and the scale scores were closely related to the global pain assessment (Spearman's rho correlation between 0.626 and 0.431). The score on the scale decreased between the day of the operation and the next day, and discriminated well between children undergoing surgery qualified as low/moderate pain and high pain. CONCLUSIONS: We conclude that the Spanish version of the PPPM scale evaluated in this study, has good psychometric properties to assess postoperative pain by parents at home.

[Evaluation of the scales used to measure anxiety and child behaviour during the induction of anaesthesia. Literature review]. / Evaluación de las escalas empleadas para determinar la ansiedad y el comportamiento del niño durante la inducción de la anestesia. Revisión de la literatura.

The assessment of children's anxiety during anaesthetic induction is useful to determine if pre-operative strategies have been effective in reducing anxiety. The aim of this study is to review the different tools used to evaluate child anxiety or behaviour during the induction of anaesthesia. The electronic databases with no date limits were reviewed in December 2013, with a second review repeated in September 2014. A data extraction template was applied to find the scales used in the articles. Eight observational scales were found. Six of them can only be used during induction of anaesthesia, and two of those could be applied at various perioperative times, before surgery and during induction of anaesthesia.

Reliability and validity of the Spanish version of the modified Yale Preoperative Anxiety Scale. / Fiabilidad y validez de la versión española de la escala de evaluación de la ansiedad prequirúrgica pediátrica modified Yale Preoperative Anxiety Scale.

INTRODUCTION AND OBJECTIVE: To minimise preoperative stress and increase child cooperation during induction of anaesthesia is one of the most important perioperative objectives. The modified Yale Preoperative Anxiety Scale was developed to evaluate anxiety. The aim of this study was to translate into Spanish, and validate the psychometric properties of the Spanish version of this scale. MATERIAL AND METHODS: The Spanish translation of the scale was performed following the World Health Organisation guidelines. During induction of anaesthesia, 81 children aged 2 to 12 years were recorded. Two observers evaluated the recordings independently. Content validity index of modified Yale Preoperative Anxiety Scale Spanish version was assessed. Weighted Kappa was calculated to measure interobserver agreement, and the Pearson correlation between the Induction Compliance Checklist and the modified Yale Preoperative Anxiety Scale was determined. RESULTS: The Spanish version obtained high content validity (0.91 to 0.98). Reliability analysis using weighted Kappa statistics revealed that interobserver agreement ranged from 0.54 to 0.75. Concurrent validity was high (r=0.94; P<.001). CONCLUSIONS: Validated assessment tools are needed to evaluate interventions to reduce child preoperative anxiety. The Spanish version of the modified Yale Preoperative Anxiety Scale evaluated in this study has shown good psychometric properties of reliability and validity.

[Opinions and attitudes of clinical staff on systems for the assessment and treatment of children's pain]. / Opiniones y actitudes del personal sanitario hacia los sistemas de evaluación y tratamiento del dolor.

INTRODUCTION: Many factors affect the assessment and treatment of pain, among them being the knowledge and attitudes of clinical staff. The goal of this work was to determine the opinions and attitudes of clinical staff from two hospitals on the different aspects of the assessment and treatment of children's pain. METHOD: A cross-sectional, descriptive study was conducted using a self-administered questionnaire issued to clinical staff. The questionnaire was given to the professionals, doctors, and nursing staff of the paediatric services of two hospitals, and to an incidental sample of paediatric doctors. RESULTS: Of the 146 questionnaires sent out, 105 were completed. Participants indicated that standardised scales and physiological recordings were the least frequently used methods to assess children's pain. Participants considered that pharmacological techniques for the treatment of pain were used more frequently than non-pharmacological techniques, at all ages. Participants acknowledged being significantly more knowledgeable about pharmacological methods to relieve paediatric pain than about non-pharmacological methods. CONCLUSIONS: There is margin for improvement in systems for the assessment and treatment of children's pain as regards the more frequent and standardised use of techniques and standardised tools for the assessment of pain, and the greater administration of non-pharmacological strategies for its treatment.

Patterns and determinants of leisure participation of youth and adults with developmental disabilities.

BACKGROUND: People with developmental disabilities are at high risk for a limited participation in leisure activities. The aim of this study was to investigate the participation in, preference for and interest in leisure activities of young and adults with developmental disabilities, and to examine the factors associated with leisure activity. METHODS: A cross-sectional design was used with a convenience sample of 237 people aged 17 to 65, living in the community. Leisure participation was assessed with the Spanish version of Leisure Assessment Inventory. Percentages were calculated by types of activity, and repeated measures anovas were used to analyse the differences between types of activities, and mixed anovas to analyse the factors that explain differences in leisure activity participation, preference and interest. RESULTS: Leisure social activities and recreation activities at home were mostly solitary and passive in nature and were identified as those being most commonly engaged in. Respondents expressed preference for more social and physical activity, and they were interested in trying out a large number of physical activities. Age and type of schooling determine participation in leisure activity. The results underscore the differences in leisure activity participation, preference and interest depending on the severity of the disability. CONCLUSIONS: The findings reveal interesting patterns of participation in leisure activities from the viewpoint of youngsters and adults with developmental disabilities. Leisure participation among people with developmental disabilities is likely to be more affected by environmental factors than by personal factors.

[Care of adolescents in Spanish hospitals: the invisible patients]. / El cuidado de los adolescentes en los hospitales españoles: los pacientes invisibles.

AIM: The general aim of this work was to address the current models of non-psychiatric hospitalization received by adolescents in Spanish hospitals. Specifically, we wished to determine whether Spanish hospitals have specific non-psychiatric admittance units for adolescent patients, what are the age limits used by such units, what diseases are cared for, and what educational and leisure services are provided for hospitalised patients. If the hospitals do not have specific admittance units for adolescent patients, we wished to find out the age limit at which minors are admitted into the paediatric unit, and where they are they admitted when they are not admitted in paediatrics, and whether alternative educational and leisure activities are provided to minor patients who are admitted in units other than paediatrics. METHOD: We carried out a descriptive study by means of surveys in 73 hospitals, of which 68 admitted minor patients. RESULTS: In most of the participating hospitals, adolescents with non-psychiatric illnesses were admitted to units that were not specifically for patients of their age. In contrast, these patients are admitted into paediatric units up to the cut-off age when they are admitted into adult units. According to the data, the most frequent cut-off age is 15 years or under. With some exceptions, when adolescents are admitted into adult units, they are not guaranteed any educational support during their hospitalization, and the leisure activities to occupy their time while hospitalized to which they have access are basically the same as those of adult patients. CONCLUSIONS: The treatment of adolescents within the Spanish hospital system has a series of deficiencies as regards international quality parameters.