Non-Communicating Children’s Pain Checklist¬–Revised: Turkish Validity and Reliability Study

Background: Pain is frequently experienced by children in intensive care units. Healthcare professionals often have difficulty assessing pain in children who are unable to communicate.
Aim: This study aimed to evaluate the validity and reliability of the Turkish version of the Non-Communicating Children’s Pain Checklist–Revised (NCCPC-R).
Methods: This methodological study was conducted in a pediatric intensive care unit between May 8, 2023 and April 8, 2024. A total of 50 children aged 3–18 years participated in the study. Data were collected using the Sociodemographic Data Form, the NCCPC-R, and the Face, Legs, Activity, Cry, and Consolability (FLACC) Scale. The NCCPC-R was translated and back-translated to establish linguistic validity, and the content validity index (CVI) was calculated. Criterion validity was evaluated by examining correlations between NCCPC-R and FLACC scores. Reliability was assessed using Cronbach’s alpha, the intraclass correlation coefficient (ICC), and test-retest analyses conducted by two independent observers at two-week intervals.
Results: The mean age of the participants was 9.08±5.31 years, and 62.0% were male. The primary medical diagnosis was neurological disorders in 64% of the children. The NCCPC-R demonstrated a CVI of 0.958. Significant positive correlations were found between NCCPC-R and FLACC scores (p<0.001). Cronbach’s alpha coefficient was 0.970. The ICC values for interrater agreement and consistency were 0.988 and 0.994, respectively (p<0.001). Test-retest reliability showed strong positive correlations for Observer 1 (r=0.811) and Observer 2 (r=0.804) (p<0.001).
Conclusion: The Turkish version of the NCCPC-R is a valid and reliable tool for assessing pain in children who are unable to communicate.

Keywords: Children, communication, pain assessment, reliability, validity