Validation of a pictorial nausea assessment scale in pediatric patients with an oncology diagnosis

Abstract

Background: Children who have been diagnosed with cancer often receive emetogenic chemotherapy as part of their treatment protocol. Baxter and colleagues (2011) developed a pictorial scale to assess nausea in children; The Baxter Animated Retching Faces Scale (BARF Scale) which has been validated for pediatric patents aged 7-18 years. A review of the literature indicated that there was no reported standardized method for assessing patient perception of their nausea when undergoing chemotherapy. Hence, effectiveness of therapeutic measures to treat nausea was seldom quantified. The purpose of this study is to compare the BARF scale to the Oncology Nursing Society (ONS) Emetogenic Risk tool to assess the relationship between emetogenic medications and self-reported nausea and to evaluate if the BARF scale could be used for patients 3 to 6.99 years of age in this population. Methods: This is a pilot feasibility study on a convenience sample using a retrospective chart review. Clarity report generated by electronic documentation system (EPIC) for data collection. ONS score calculated for medication. Aim 1: Generalized Estimating Equation (GEE) to compare nausea scores before and after intervention. Aim 2: Repeated measures correlation coefficient of ONS scores and the highest recorded nausea scores for each admission. Findings: N=70 ,99.1% of children selected 0 on the BARF scale when not nauseated, and if reported nausea were able to discriminate between the faces based on symptoms. There was a significant decrease in nausea scores after any intervention (-0.749 points, 95% CI (-1.237, -0.262), p=0.003). No significant correlation between ONS and nausea scores in either the whole cohort or subset by age.