School of Nursing, National Defense Medical Center, Taipei, Taiwan.
J Clin Nurs. 2012 Jan;21(1-2):89-100. doi: 10.1111/j.1365-2702.2011.03770.x. Epub 2011 Jul 18.
To determine the inter-rater reliability, internal consistency, construct and concurrent validity and feasibility of the pain assessment scale for preterm infants.
Repeated exposure to painful procedures has an adverse impact on preterm infants' health outcomes. Although many scales are available for assessing these infants' pain, only a few reliably and validly assess pain and no gold standard has been established in clinical practice.
Instrument development and psychometric analysis.
Preterm infants (n = 60) born 27·6-36·3 weeks gestational age were assessed for pain 3 minutes before (phase I), during (phase II), 3 minutes after (phase III) and the tenth minute after (phase IV) heel-stick procedures. Pain scores were independently coded from video recordings and observations by three trained nurses using our pain-assessment scale, premature infant pain profile and visual analogue scale.
Scores on the pain assessment scale for preterm infants differed significantly across four phases of heel-stick procedures (F = 56·86, p < 0·0001). Internal consistency was 0·84 and inter-rater reliability was 0·88-0·93. Scores on our pain scale correlated well with scores on the premature infant pain profile (0·74-0·83) and visual analogue scale (0·72-0·81).
The pain assessment scale for preterm infants integrates all possible pain indicators, with each item modified for clinicians' simple and easy pain measurement to potentially yield different information. Our scale is valid, reliable and feasible for preterm infants with gestational age > 27 weeks. Further examination of the scale's psychometrics is recommended with diverse samples of infants and different painful procedures.
The pain assessment scale for preterm infants clearly defines item scoring and weighting, consistently discriminates different levels of pain and helps nurses to recognise infants' pain. Nurses can easily remember the definition of each item, allowing them to use our scale to evaluate preterm infants' pain at any time and to provide pain-relief interventions when needed.
确定早产儿疼痛评估量表的评定者间信度、内部一致性、结构效度和同时效度及可行性。
反复经历疼痛操作会对早产儿的健康结局产生不良影响。虽然有许多量表可用于评估这些婴儿的疼痛，但只有少数几个能够可靠且有效地评估疼痛，而且在临床实践中尚未确立金标准。
工具开发和心理计量学分析。
对胎龄 27.6-36.3 周的早产儿在足跟采血前 3 分钟（阶段 I）、采血时（阶段 II）、采血后 3 分钟（阶段 III）和采血后第 10 分钟（阶段 IV）进行疼痛评估。3 名经过培训的护士从视频记录和观察中独立对疼痛评分进行编码，使用我们的早产儿疼痛评估量表、早产儿疼痛特征评估量表和视觉模拟评分法。
早产儿疼痛评估量表的评分在足跟采血的 4 个阶段之间差异有统计学意义（F = 56.86，p < 0.0001）。内部一致性为 0.84，评定者间信度为 0.88-0.93。我们的疼痛量表评分与早产儿疼痛特征评估量表（0.74-0.83）和视觉模拟评分法（0.72-0.81）的评分相关性良好。
早产儿疼痛评估量表整合了所有可能的疼痛指标，每个项目都经过了修改，以便临床医生进行简单、易于操作的疼痛测量，从而可能提供不同的信息。对于胎龄＞27 周的早产儿，我们的量表是有效、可靠和可行的。建议使用不同样本的婴儿和不同的疼痛操作进一步检验量表的心理计量学特性。
早产儿疼痛评估量表清楚地定义了项目评分和权重，能一致地区分不同水平的疼痛，并帮助护士识别婴儿的疼痛。护士可以很容易地记住每个项目的定义，从而可以随时使用我们的量表评估早产儿的疼痛，并在需要时提供疼痛缓解干预。
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