McNair C, Ballantyne M, Dionne K, Stephens D, Stevens B
Hospital for Sick Children, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Arch Dis Child Fetal Neonatal Ed. 2004 Nov;89(6):F537-41. doi: 10.1136/adc.2003.032961.
To compare the convergent validity of two measures of pain (premature infant pain profile (PIPP) and crying, requires oxygen, increased vital signs, expression, and sleepless (CRIES)) in real life postoperative pain assessment in infants.
This study was a prospective, repeated measures, correlational design. Two staff nurses were randomly assigned either the PIPP or CRIES measure. An expert rater assessed each infant after surgery, and once a day using the visual analogue scale (VAS).
A level III neonatal intensive care unit in a metropolitan university affiliated paediatric hospital.
Pain was assessed in 51 neonates (28-42 weeks of gestational age) after surgery. There was no significant difference in the rates of change between the pain assessment measures across time using repeated measures analysis of variance (F(50,2) = 0.62, p = 0.540), indicating correlation between the measures. Convergent validity analysis using intraclass correlation showed correlation, most evident in the first 24 hours (immediately, 4, 8, 20, and 24 hours after the operation). Correlations were more divergent at 40 and 72 hours after surgery. No significant interactions were found between gestational age and measure (F(304,4) = 0.75, p = 0.563) and surgical group and measure (F(304,2) = 0.39, p = 0.680).
PIPP and CRIES are valid measures that correlate with pain for the first 72 hours after surgery in term and preterm infants. Both measures would provide healthcare professionals with an objective measure of a neonatal patient's pain.
比较两种疼痛评估方法（早产儿疼痛量表（PIPP）和哭声、吸氧需求、生命体征增加、表情及睡眠不安（CRIES））在婴儿术后实际疼痛评估中的收敛效度。
本研究采用前瞻性、重复测量、相关性设计。两名护士被随机分配使用PIPP或CRIES评估方法。一名专家评估员在术后对每名婴儿进行评估，并每天使用视觉模拟量表（VAS）进行一次评估。
一所大都市大学附属医院的三级新生儿重症监护病房。
对51例术后新生儿（胎龄28 - 42周）进行了疼痛评估。使用重复测量方差分析，各疼痛评估方法随时间的变化率无显著差异（F(50,2) = 0.62，p = 0.540），表明两种评估方法具有相关性。使用组内相关系数进行的收敛效度分析显示存在相关性，在术后最初24小时（术后即刻、4、8、20和24小时）最为明显。术后40和72小时相关性差异更大。未发现胎龄与评估方法之间（F(304,4) = 0.75，p = 0.563）以及手术组与评估方法之间（F(304,2) = 0.39，p = 0.680）存在显著交互作用。
PIPP和CRIES是有效的评估方法，与足月儿和早产儿术后72小时内的疼痛相关。这两种评估方法都能为医护人员提供新生儿患者疼痛的客观评估指标。
