In this study, we describe the development and validation of a revised Pediatric Chronic Pain Grading (P-CPG) for children aged 8 to 17 years that adds emotional impairment to previously used measures of pain intensity and functional impairment. Such a measure enables the assessment of chronic pain severity in different epidemiological and clinical populations, the stratification of treatment according to pain severity, and the monitoring of treatment outcome. The P-CPG was developed using a representative sample of school children with chronic pain (n = 454; Mage = 12.95, SD = 2.22). Construct validity and sensitivity to change were examined within a sample of N = 2448 children and adolescents (Mage = 12.71, SD = 2.47) comprising 3 subsamples (school n = 1562, primary care n = 129, and tertiary care n = 757) affected by chronic pain to varying extents. Results showed that P-CPG grades differed significantly among the 3 subsamples, with school children being least affected by chronic pain and tertiary care patients being most affected. As P-CPG grade increased, so did pain intensity, functional impairment, pain-related school absence, and emotional impairment. Convergent validity was demonstrated by significant positive correlations between the P-CPG and global ratings of pain severity as well as objective claims data; the latter reflects greater health care costs with increasing P-CPG scores. Sensitivity to change was supported by a significant reduction in baseline P-CPG grades 3 and 6 months after intensive interdisciplinary pain treatment in tertiary care sample. In conclusion, the P-CPG is an appropriate measure of pain severity in children and adolescents with chronic pain in clinical as well as epidemiological settings.

中文翻译：

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小儿慢性疼痛分级——小儿慢性疼痛严重程度的修订分类。

在这项研究中，我们描述了针对 8 至 17 岁儿童的修订版小儿慢性疼痛分级 (P-CPG) 的开发和验证，该分级在以前使用的疼痛强度和功能障碍测量中增加了情绪障碍。这种措施可以评估不同流行病学和临床人群的慢性疼痛严重程度，根据疼痛严重程度对治疗进行分层，并监测治疗结果。 P-CPG 是使用患有慢性疼痛的学童的代表性样本制定的（n = 454；Mage = 12.95，SD = 2.22）。在 N = 2448 名儿童和青少年（Mage = 12.71，SD = 2.47）样本中检查了结构有效性和对变化的敏感性，该样本包括 3 个受影响的子样本（学校 n = 1562、初级保健 n = 129 和三级保健 n = 757）不同程度的慢性疼痛。结果显示，3 个子样本的 P-CPG 等级差异显着，学童受慢性疼痛影响最小，三级护理患者受影响最大。随着 P-CPG 等级的增加，疼痛强度、功能障碍、与疼痛相关的缺课和情绪障碍也随之增加。 P-CPG 与疼痛严重程度的全球评级以及客观索赔数据之间的显着正相关性证明了收敛效度；后者反映了随着 P-CPG 分数的增加，医疗保健费用也随之增加。三级护理样本中经过强化跨学科疼痛治疗后 3 个月和 6 个月基线 P-CPG 等级显着降低，支持了对变化的敏感性。总之，P-CPG 是临床和流行病学背景下患有慢性疼痛的儿童和青少年疼痛严重程度的适当衡量标准。