*The Hospital for Sick Children †Lawrence S. Bloomberg Faculty of Nursing ¶Leslie Dan Faculty of Pharmacy, The University of Toronto, Toronto, ON ‡The Credit Valley Hospital Trillium Health Centre, Mississauga, ON §Ingram School of Nursing, McGill University, Montréal, QC ∥IWK Health Centre, Halifax, NS, Canada.
Clin J Pain. 2014 Mar;30(3):238-43. doi: 10.1097/AJP.0b013e3182906aed.
To describe revisions to the Premature Infant Pain Profile (PIPP) and initial construct validation and feasibility of the Premature Infant Pain Profile-Revised (PIPP-R).
The PIPP was revised to enhance validity and feasibility. To validate the PIPP-R, data from 2 randomized cross-over studies were utilized to: (1) calculate and compare PIPP and PIPP-R scores in extremely low gestational age infants undergoing a painful and nonpainful event (N=52; dataset #1) and (2) calculate and compare PIPP and PIPP-R scores in assessing the effectiveness of (a) sucrose, (b) non-nutritive sucking (NNS)+sucrose, and (c) facilitated tucking+NNS+sucrose during heel lance (N = 85; dataset #2). Pearson correlations between PIPP and PIPP-R scores were calculated, and Student t tests and 1-way analysis of variance were used to determine construct validity during painful and nonpainful events. To establish feasibility, a survey of 31 Neonatal Intensive Care Unit nurses was conducted.
PIPP-R scores were significantly lower during nonpainful (mean, 8.3; SD = 2.9) compared with painful (mean, 9.9; SD=3.1; t95 = 4.51, P = 0.036) events in extremely low gestational age infants in dataset #1. In dataset #2, PIPP-R scores were significantly lower in infants 25 to 41 weeks gestation in the group receiving NNS+sucrose compared with the other 2 groups (F2,79 = 2.9, P<0.05). Overall, nurses rated the PIPP-R as feasible.
Initial construct validation and feasibility of the PIPP-R was demonstrated. Further testing with infants of varying gestational ages, diagnoses, and pain conditions is required; as is exploration of PIPP-R in relation to other types of physiological and cognitive responses.
描述早产儿疼痛行为量表（PIPP）的修订版，并初步验证其结构效度和可行性。
对 PIPP 进行修订以提高其有效性和可行性。为了验证 PIPP-R，我们利用了 2 项随机交叉研究的数据：（1）比较极低胎龄儿在经历疼痛和非疼痛事件时的 PIPP 和 PIPP-R 评分（N=52；数据集 #1），以及（2）比较评估蔗糖、非营养性吸吮（NNS）+蔗糖、和（c）促进包裹+NNS+蔗糖在足跟采血时的有效性的 PIPP 和 PIPP-R 评分（N = 85；数据集 #2）。计算 PIPP 和 PIPP-R 评分之间的 Pearson 相关系数，并采用学生 t 检验和单因素方差分析来确定在疼痛和非疼痛事件中的结构效度。为了确定可行性，对 31 名新生儿重症监护病房护士进行了调查。
在数据集 #1 中，极低胎龄儿在非疼痛事件时的 PIPP-R 评分明显低于疼痛事件（均值，8.3；SD = 2.9）（均值，9.9；SD = 3.1；t95 = 4.51，P = 0.036）。在数据集 #2 中，胎龄 25 至 41 周的婴儿在接受 NNS+蔗糖组的 PIPP-R 评分明显低于其他 2 组（F2,79 = 2.9，P<0.05）。总体而言，护士认为 PIPP-R 是可行的。
初步验证了 PIPP-R 的结构效度和可行性。需要对不同胎龄、诊断和疼痛状况的婴儿进行进一步测试；并探索 PIPP-R 与其他类型的生理和认知反应的关系。
