Pain management nursing : official journal of the American Society of Pain Management Nurses · 2026
Validation of the Emoji Faces Pain Scale for Evaluating Acute Procedural Pain in Children Aged 3-5 Years.
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Wan Xin, Leng Hongyao, Shen Qiao, Hu Jinjiu, Yan Li, Zheng Xianlan
Аннотация
PURPOSE: To evaluate the measurement performance and clinical feasibility of the Emoji‑FPS for acute procedural pain assessment in children aged 3-5 years, compared with the Wong-Baker FACES Pain Rating Scale (WBFPS).
DESIGN: This was an observational study.
METHODS: A total of 192 children aged 3-5 years self-reported acute procedural pain using both the Emoji‑FPS and the WBFPS within 5 minutes of routine clinical procedures. Agreement between the two scales and responsiveness of Emoji-FPS were analyzed, and receiver operating characteristic analysis was used to establish pain severity cutoffs. Clinical feasibility based on observed child performance and scale preference were assessed.
RESULTS: The Emoji‑FPS showed strong agreement with the WBFPS. Clinical feasibility improved with age, with 57.69% of 3-year-old children, 75.95% of 4-year-old children, and 89.66% of 5-year-old children reporting that the scale was easy to use. Overall, 67.19% of children preferred the Emoji‑FPS.
CONCLUSIONS: The Emoji-FPS was able to effectively distinguish between mild, moderate, and severe pain in children aged 3-5 years who were able to understand the scale and complete the rating in acute procedural pain settings, and accurately reflected changes in pain before and after procedure.
CLINICAL IMPLICATIONS: The Emoji Faces Pain Scale may support procedural pain assessment in preschool-aged children and should be interpreted alongside clinical judgment.
DESIGN: This was an observational study.
METHODS: A total of 192 children aged 3-5 years self-reported acute procedural pain using both the Emoji‑FPS and the WBFPS within 5 minutes of routine clinical procedures. Agreement between the two scales and responsiveness of Emoji-FPS were analyzed, and receiver operating characteristic analysis was used to establish pain severity cutoffs. Clinical feasibility based on observed child performance and scale preference were assessed.
RESULTS: The Emoji‑FPS showed strong agreement with the WBFPS. Clinical feasibility improved with age, with 57.69% of 3-year-old children, 75.95% of 4-year-old children, and 89.66% of 5-year-old children reporting that the scale was easy to use. Overall, 67.19% of children preferred the Emoji‑FPS.
CONCLUSIONS: The Emoji-FPS was able to effectively distinguish between mild, moderate, and severe pain in children aged 3-5 years who were able to understand the scale and complete the rating in acute procedural pain settings, and accurately reflected changes in pain before and after procedure.
CLINICAL IMPLICATIONS: The Emoji Faces Pain Scale may support procedural pain assessment in preschool-aged children and should be interpreted alongside clinical judgment.