Subjective pediatric assessment scar scale — SPASS. Development and validation of the scale

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Abstract

Background. A skin scar is an important component of satisfaction with surgical treatment. Both the patient’s comfort level and the possible treatment tactics depend on the variant of scarring changes.

Aim. Development of a new instrument for assessing a skin scar in a child. It should take into account the requirements of clinometric.

Methods. A total of 170 children participated in the study at various stages of the development and validation of the scale. The study period is from 2021 to 2024. The procedures of exploratory factor analysis and multiple regression analysis were carried out, taking into account all the standard criteria necessary for this.

Results. The Subjective pediatric assessment scar scale (SPASS) perception consists of three sheets with questions. Each of them is intended for personal filling by the child, his parent and, finally, the doctor. The questionnaire sheets for children are divided depending on the age periodization. The average level of inter–expert reliability among doctors was 0.96 (95% CI 0.93–0.99). Intra–expert reliability had a variation from 0.85 (95% CI 0.88–0.82) to 0.97 (95% CI 0.95–0.99). The overal convergent validity value for the questionnaire was 0.95. The overall Cronbach’s alpha level among parents was 0.83. The overall subjective assessment of a skin scar significantly correlates positively with the following indicators: social aspects of the presence of a scar (R0 = 0.899, p < 0.001), physical inconveniences (R0 = 0.835, p < 0.001), problems of aesthetics and treatment (R0 = 0.733, p < 0.001).

Conclusion. The developed SPASS is the first tool of its kind to be used among children. The questionnaire is adapted for children of different ages, taking into account the periodization of mental development. The scale is ready for use in clinical practice.

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About the authors

Dmitry S. Savelyev

Razumovsky Saratov State Medical University

Author for correspondence.
Email: saveljevds@gmail.com
ORCID iD: 0009-0006-6832-3318
SPIN-code: 6057-3390
Россия, Saratov

Sergey Yu. Gorodkov

Razumovsky Saratov State Medical University

Email: gorodcov@yandex.ru
ORCID iD: 0000-0001-9281-6872
SPIN-code: 2458-6382

MD, Cand. Sci. (Medicine), Associate Professor

Россия, Saratov

Igor V. Goremykin

Razumovsky Saratov State Medical University

Email: goremykine@gmail.com
ORCID iD: 0000-0002-6074-9780
SPIN-code: 4172-3482

MD, Dr. Sci. (Medicine), Professor

Россия, Saratov

Maria V. Bratashova

Chernyshevsky Saratov State University

Email: bratashovamv@gmail.com
ORCID iD: 0000-0002-4253-0259
SPIN-code: 5426-8101
Россия, Saratov

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3. Fig. 2. Residual plot regression.

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Copyright (c) 2025 Savelyev D.S., Gorodkov S.Y., Goremykin I.V., Bratashova M.V.

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