Bellieni Carlo V, Bagnoli Franco, Sisto Renata, Neri Laura, Cordelli Duccio, Buonocore Giuseppe
Department of Paediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy.
Acta Paediatr. 2005 Oct;94(10):1432-6. doi: 10.1111/j.1651-2227.2005.tb01816.x.
We developed and validated a pain scale (ABC scale) for term babies based on acoustic features of crying.
The scale consisted of three different cry parameters: (a) pitch of the first cry; (b) rhythmicity of the crying bout; (c) constancy of crying intensity. These parameters were previously found to distinguish between medium and high levels of pain measured by spectral analysis of crying. We validated the scale using healthy term babies undergoing routine heel prick. Concurrent validity was assessed comparing pain values obtained with our scale with those obtained with another pain scale; this relationship was also used to assess the sensitivity of the scale. To assess specificity we compared the ABC scores during a painful event (heel prick) with two non-painful events (preliminary phase of prick in the same group of babies, and heel prick with analgesia in another group).
Specificity: (a) analgesic/non-analgesic comparison, p < 0.0001; (b) pain/sham comparison, p < 0.0001). Sensitivity: a high correlation between scores of the ABC scale and the Douleur Aigue du Nouveau-Né scale indicates good sensitivity. Concurrent validity: Spearman rho = 0.91. Internal consistency: Cronbach's alpha = 0.76. Inter-rater reliability: Cohen's kappa for multiple raters = 0.83. Intra-rater reliability: Cohen's kappa = 0.85. Practicality: All nurses who used it scored the scale as "good".
The ABC scale proved to be simple and reliable for assessing pain in healthy, non-intubated term newborns.
我们基于哭声的声学特征开发并验证了一种用于足月儿的疼痛量表（ABC量表）。
该量表由三个不同的哭声参数组成：（a）第一声啼哭的音高；（b）哭声发作的节律性；（c）哭声强度的稳定性。先前通过哭声频谱分析发现这些参数可区分中度和高度疼痛水平。我们使用接受常规足跟采血的健康足月儿对该量表进行了验证。通过将我们的量表获得的疼痛值与另一种疼痛量表获得的疼痛值进行比较来评估同时效度；这种关系也用于评估该量表的敏感性。为了评估特异性，我们将疼痛事件（足跟采血）期间的ABC评分与两个非疼痛事件（同一组婴儿采血的初始阶段，以及另一组婴儿使用镇痛剂的足跟采血）进行了比较。
特异性：（a）镇痛/非镇痛比较，p<0.0001；（b）疼痛/假手术比较，p<0.0001）。敏感性：ABC量表评分与新生儿急性疼痛量表之间的高度相关性表明敏感性良好。同时效度：Spearman相关系数=0.91。内部一致性：Cronbach's alpha=0.76。评分者间信度：多位评分者的Cohen's kappa=0.83。评分者内信度：Cohen's kappa=0.85。实用性：所有使用该量表的护士都将其评为“良好”。
ABC量表被证明对于评估健康、未插管的足月儿的疼痛简单且可靠。
