Andersen Randi Dovland, Munsters Josanne M A, Vederhus Bente Johanne, Gradin Maria
Department of Child and Adolescent Health Services, Telemark Hospital, Skien, Norway.
Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Scand J Caring Sci. 2018 Sep;32(3):1074-1082. doi: 10.1111/scs.12553. Epub 2017 Dec 28.
The use of measurement scales to assess pain in neonates is considered a prerequisite for effective management of pain, but these scales are still underutilised in clinical practice.
The aim of this study was to describe and compare pain assessment practices including the use of pain measurement scales in Norwegian and Swedish neonatal care units.
A unit survey investigating practices regarding pain assessment and the use of pain measurement scales was sent to all neonatal units in Sweden and Norway (n = 55). All Norwegian and 92% of Swedish units responded.
A majority of the participating units (86.5%) assessed pain. Swedish units assessed and documented pain and used pain measurement scales more frequently than Norwegian units. The most frequently used scales were different versions of Astrid Lindgren's Pain Scale (ALPS) in Sweden and Echelle Douleur Inconfort Noveau-Ne (EDIN), ALPS and Premature Infant Pain Profile (PIPP) in Norway. Norwegian head nurses had more confidence in their pain assessment method and found the use of pain measurement scales more important than their Swedish colleagues.
The persisting difference between Swedish and Norwegian units in pain assessment and the use of pain measurement scales are not easily explained. However, the reported increased availability and reported use of pain measurement scales in neonatal care units in both countries may be seen as a contribution towards better awareness and recognition of pain, better pain management and potentially less suffering for vulnerable neonates.
使用测量量表评估新生儿疼痛被认为是有效管理疼痛的先决条件，但这些量表在临床实践中仍未得到充分利用。
本研究的目的是描述和比较挪威和瑞典新生儿重症监护病房的疼痛评估实践，包括疼痛测量量表的使用情况。
向瑞典和挪威的所有新生儿重症监护病房（n = 55）发送了一份关于疼痛评估实践和疼痛测量量表使用情况的单位调查问卷。所有挪威单位和92%的瑞典单位进行了回复。
大多数参与单位（86.5%）进行了疼痛评估。瑞典单位比挪威单位更频繁地评估和记录疼痛，并使用疼痛测量量表。瑞典最常用的量表是不同版本的阿斯特丽德·林德格伦疼痛量表（ALPS），挪威则是新生儿疼痛不适量表（EDIN）、ALPS和早产儿疼痛量表（PIPP）。挪威的护士长对其疼痛评估方法更有信心，并且比瑞典同事更重视疼痛测量量表的使用。
瑞典和挪威单位在疼痛评估及疼痛测量量表使用方面持续存在的差异难以解释。然而，报告显示两国新生儿重症监护病房疼痛测量量表的可获得性和使用有所增加，这可被视为有助于提高对疼痛的认识和识别、改善疼痛管理，并可能减少脆弱新生儿的痛苦。
