# Reliability and Validity of the Swedish Version of the Parents' Postoperative Pain Measure (PPPM‐S): A Cross‐Sectional Psychometric Study

## TL;DR

This study validates a Swedish version of a tool for parents to assess their child's postoperative pain at home, showing it is reliable and effective.

## Contribution

The study provides a validated Swedish version of the PPPM-S for home-based postoperative pain assessment in children.

## Key findings

- The PPPM-S showed good internal consistency (Cronbach's alpha 0.842–0.851) and strong correlations with the CAS (Spearman's rho = 0.683–0.630).
- An optimal cut-off score of 5/15 was identified with acceptable sensitivity and specificity.

## Abstract

As paediatric day surgery becomes increasingly common, postoperative care is transferred to the home setting where parents play a central role in assessing and managing their child's postoperative pain. No validated Swedish instrument currently exists to support parents in evaluating their child's pain at home.

To assess the reliability and validity of the Swedish translation of the PPPM‐S in children aged 2–12 years during the first two postoperative days.

The instrument was earlier translated from English into Swedish in accordance with the WHO Guidelines for translation and adaptation of an instrument. A backward‐forward translation was done with a bilingual expert panel, and cognitive interviews were done in the target population. This study was conducted at three Swedish hospitals between 2022 and 2025 involving 80 parents of children aged 2–12 years who underwent day surgery. Parents completed the PPPM‐S on postoperative days 1 and 2. To evaluate the accuracy of the instrument, the results were compared with scores from an established pain rating scale, the Coloured Analogue Scale (CAS).

PPPM‐S demonstrated good psychometric properties: good internal consistency (Cronbach's alpha 0.842–0.851) and satisfactory criterion validity demonstrated by strong correlations with CAS (Spearman's rho = 0.683–0.630, p < 0.01). ROC analysis identified 5/15 as an optimal cut‐off, with acceptable sensitivity and specificity. Parents reported high levels of satisfaction and found it easy to use at home.

The PPPM‐S is a valid and practical tool for assessing children's postoperative pain at home. It can help parents better understand and evaluate their child's pain, potentially improving postoperative care in the home setting.