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

This was a validation study of a parent-report questionnaire, not a test of whether using the checklist improves pain control. Only 80 parents were analysed from 136 invited (62% response), and nonrespondents may have had different experiences. Parents who could not read or write Swedish were excluded, so the results apply only to Swedish-speaking parents who can read the form. No a priori sample size calculation was done, although 80 participants met COSMIN recommendations. The study did not assess whether the checklist distinguishes mild, moderate, or severe pain, and only one parent per child was included, so agreement between caregivers was not tested. Follow-up was only two days after surgery, so it does not address pain after more extensive surgery or later recovery. For children under 5, the Coloured Analogue Scale was rated by parents, not self-reported, and the paper notes no validated home instrument for this group. The text and Table 3 give opposite day-by-day Cronbach alpha values, so exact day-specific reliability is unclear.

The study was partially funded by the Research and Development Council of Region Östergötland, and the authors declare no conflicts of interest.

Do not conclude that the PPPM-S is proven to improve children's pain control. It was validated against the Coloured Analogue Scale in 80 parent-child pairs after day surgery, and the 5/15 cut-off is a threshold for identifying pain, not a tested treatment rule.