Needle fear is a common problem in children undergoing immunization. To ensure that the individual child�s needs are met during a\npainful procedure itwould be beneficial to be able to predictwhether there is a need for extra support.Theself-reporting instrument\nfacial affective scale (FAS) could have potential for this purpose. The aim of this study was to evaluate whether the FAS can predict\npain unpleasantness in girls undergoing immunization. Girls, aged 11-12 years, reported their expected pain unpleasantness on the\nFAS at least two weeks before and then experienced pain unpleasantness immediately before each vaccination. The experienced\npain unpleasantness during the vaccination was also reported immediately after each immunization. The level of anxiety was\nsimilarly assessed during each vaccination and supplemented with stress measures in relation to the procedure in order to assess\nand evaluate concurrent validity.The results show that the FAS is valid to predict pain unpleasantness in 11-12-year-old girls who\nundergo immunizations and that it has the potential to be a feasible instrument to identify children who are in need of extra support\nto cope with immunization. In conclusion, the FAS measurement can facilitate caring interventions
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