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* The success of the Wong-Baker FACES Pain Rating Scale has far exceeded our expectation. We have received numerous requests for the scale and for various types of information, one of them being the development of the instrument. In 1981, Donna Wong, a nurse consultant, and Connie Morain Baker, a child life specialist, were working in the burn center at Hillcrest Medical Center, Tulsa, OK. We frequently saw children who were in pain, and because of their young age, had difficulty communicating how they were feeling. Many times their complaints and cries were misunderstood by the staff, and their pain was not effectively controlled. We believed that we would be able to assess their pain better if the children were given the proper tools to communicate with. When we reviewed the literature, we found several scales that had been used with adults and some tools that had been developed for children, such as those using colors, chips, and one unpublished paper that had used 4 different faces. We adapted a few of the adult scales and used the existing pediatric tools. During our initial attempts to find a scale that the children could use, we did not develop our ideas in terms of a research project but were primarily interested in developing a usable clinical instrument. Through experience we found that young children had considerable difficulty using any scale with a number concept, a ranking concept, or unfamiliar words. Many young children did not know colors sufficiently well to create their own color scale. However, we found that children seemed to respond well to facial expressions, and we believed that a series of faces (with numbers primarily for our own ranking purposes) would be useful for children. However, aside from the one thesis research (Alyea, 1978), we were not aware of any other work that used faces to rate pain. Stickers were very popular during the 1980s and we often used them to reinforce cooperation during burn treatments or other phases of care. We
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