Xu Wanli, Walsh Stephen, Cong Xiaomei S
University of Connecticut School of Nursing, Storrs, Connecticut.
University of Connecticut School of Nursing, Storrs, Connecticut.
Pain Manag Nurs. 2016 Dec;17(6):354-362. doi: 10.1016/j.pmn.2016.08.004. Epub 2016 Oct 15.
High-risk neonates experience numerous painful/stressful procedures daily in neonatal intensive care units (NICUs). Accumulated pain and stress have a detrimental impact on infants' neurodevelopment. Few valid tools are available to measure accumulated pain/stressors among NICU infants. The aim of this study was to obtain nurses' perceptions about severity and acuity levels regarding each painful/stressful procedure that infants may experience in the NICU. The data will support developing a new instrument, the Accumulated Pain/Stressor Scale (APSS) in NICUs. A nationwide online survey was conducted through the U.S. National Association of Neonatal Nurses membership. Respondents were asked to rate the perceived severity of pain/stress associated with 68 procedures using a 5-point Likert scale and to categorize pain/stress as acute or chronic. Modal values were used to determine summary rankings among the procedures. Eighty-four neonatal nurses completed the survey. Among 68 procedures, nearly all were rated as painful/stressful to some degree. Five procedures (7%) had a modal value of five (extremely painful/stressful), nine (14%) had a value of four, 20 (29%) had a value of three, 30 (44%) a value of two, and four (6%) had a value of one (not painful/stressful). Forty-four procedures (65%) were perceived as acute, six (9%) as chronic, and 18 (26%) as both acute and chronic. Nurses' perceptions of pain severity and acuity regarding procedures in NICUs varied somewhat. Further studies are needed in developing and validating the scale. The development of the APSS can quantitatively measure the accumulated neonatal pain/stress.
高危新生儿每天在新生儿重症监护病房（NICU）要经历无数次痛苦/有压力的操作。累积的疼痛和压力对婴儿的神经发育有不利影响。几乎没有有效的工具可用于测量NICU婴儿累积的疼痛/压力源。本研究的目的是了解护士对婴儿在NICU可能经历的每种痛苦/有压力操作的严重程度和急性程度的看法。这些数据将支持开发一种新工具，即NICU累积疼痛/压力源量表（APSS）。通过美国国家新生儿护士协会会员进行了一项全国性在线调查。要求受访者使用5点李克特量表对与68种操作相关的疼痛/压力的感知严重程度进行评分，并将疼痛/压力分为急性或慢性。使用众数来确定各项操作之间的综合排名。84名新生儿护士完成了调查。在68种操作中，几乎所有操作在某种程度上都被评为有痛苦/有压力。5种操作（7%）的众数为5（极其痛苦/有压力），9种（14%）为4，20种（29%）为3，30种（44%）为2，4种（6%）为1（无痛苦/无压力）。44种操作（65%）被视为急性，6种（9%）为慢性，18种（26%）既为急性又为慢性。护士对NICU操作的疼痛严重程度和急性程度的看法略有不同。在开发和验证该量表方面还需要进一步研究。APSS的开发可以定量测量新生儿累积的疼痛/压力。
