Gessler P, Cignacco E
Universitäts-Kinderklinik, Zurich, Switzerland.
Klin Padiatr. 2004 Jan-Feb;216(1):16-20. doi: 10.1055/s-2004-817682.
Neonate's expression of pain lacks the ability to report pain. Several pain measures exist to assess acute pain in term and preterm neonates. The aim of the present study is to compare them with respect to their validity and reliability.
Review of the literature and a description of the measures most often cited. Additionally, the validity of the Bernese Pain Scale for Neonates (BPSN) was assessed in a department of neonatology of a university hospital.
Assessments of pain (n = 48) in term and preterm neonates with and without respiratory support.
Existing pain measures are using behavioural indicators of pain (eg, facial expression, body posture, movements, and vigilance) as well as physiological indicators of pain (eg, changes in heart rate, respiratory rate, blood pressure, oxygen saturation). The used measures and their feasibility in everyday practice, the study population and the method of validation were presented. The BPSN differentiates pain from nonpain (F = 41.27, p < 0.0001) and the interrater- as well as the intrarater-reliability was high (r = 0.87 - 0.98 and r = 0.98 - 0.99, respectively).
Assessment of acute pain in neonates should take into account the way of validation that has been performed especially with respect to the study population. The BSN is a pain measure with good validity and reliability for the assessment of pain in term and preterm neonates.
新生儿无法通过言语报告疼痛。目前存在多种疼痛评估方法用于评估足月儿和早产儿的急性疼痛。本研究旨在比较这些方法的有效性和可靠性。
回顾文献并描述最常被引用的评估方法。此外，在一家大学医院的新生儿科评估了伯尔尼新生儿疼痛量表（BPSN）的有效性。
对有和没有呼吸支持的足月儿和早产儿进行疼痛评估（n = 48）。
现有的疼痛评估方法使用疼痛的行为指标（如面部表情、身体姿势、动作和警觉性）以及疼痛的生理指标（如心率、呼吸频率、血压、血氧饱和度的变化）。介绍了所使用的评估方法及其在日常实践中的可行性、研究人群和验证方法。BPSN能够区分疼痛和非疼痛（F = 41.27，p < 0.0001），评分者间信度和评分者内信度都很高（分别为r = 0.87 - 0.98和r = 0.98 - 0.99）。
评估新生儿急性疼痛时应考虑所采用的验证方式，尤其是针对研究人群的验证方式。BSN是一种评估足月儿和早产儿疼痛有效性和可靠性良好的疼痛评估方法。
