Bellieni Cv, Maffei M, Ancora G, Cordelli D, Mastrocola M, Faldella G, Ferretti E, Buonocore G
Department of Pediatrics, Obstetrics and Reproduction Medicine, University of Siena, Siena, Italy.
Acta Paediatr. 2007 Jul;96(7):1008-10. doi: 10.1111/j.1651-2227.2007.00355.x.
We recently developed the ABC scale to assess pain in term newborns. The aim of the present study was to assess the reliability of the scale in preterm babies.
The scale consists of three cry parameters: (a) pitch of the first cry, (b) rhythmicity of the bout of crying and (c) cry constancy. Changes in these parameters were previously found to distinguish medium and high levels of pain as evaluated by spectral analysis of crying. We enrolled 72 babies to perform the steps usually requested to validate a scale, namely the study of the concurrent validity, specificity and sensibility. Moreover, we assessed the interjudge reliability and the clinical utility and ease of the scale.
A good correlation (r = 0.68; r(2)= 0.45; p < 0.0001) was found between scores obtained with the ABC scale and the premature infant pain profile (PIPP) scale, demonstrating a good concurrent validity. The scale also showed good sensitivity and specificity (we found statistically significant differences between mean values of scores obtained in babies who underwent pain and babies who underwent non-painful stimulus.) Interobserver reliability was good: Cohen's kappa = 0.7.
The good correlation between the two scales shows that the ABC scale is also reliable for premature babies.
我们最近开发了ABC量表来评估足月儿的疼痛。本研究的目的是评估该量表在早产儿中的可靠性。
该量表由三个哭声参数组成：（a）第一声哭声的音高，（b）哭声发作的节奏性，以及（c）哭声持续性。先前通过哭声频谱分析发现，这些参数的变化可区分中度和高度疼痛水平。我们招募了72名婴儿，以执行通常用于验证量表的步骤，即同时效度、特异性和敏感性的研究。此外，我们评估了评判者间的可靠性以及该量表的临床实用性和易用性。
ABC量表得分与早产儿疼痛量表（PIPP）得分之间存在良好的相关性（r = 0.68；r² = 0.45；p < 0.0001），表明具有良好的同时效度。该量表还显示出良好的敏感性和特异性（我们发现在接受疼痛刺激的婴儿和接受非疼痛刺激的婴儿中获得的得分平均值之间存在统计学上的显著差异）。观察者间的可靠性良好：科恩kappa系数 = 0.7。
两个量表之间的良好相关性表明，ABC量表对早产儿也可靠。
