Department of Psychology, York University, Toronto, Ontario, Canada.
Department of Psychology, York University, Toronto, Ontario, Canada; Department of Psychiatry Research, Hospital for Sick Children, Toronto, Ontario, Canada; Departments of Psychiatry and Pharmacy, University of Toronto, Toronto, Ontario, Canada.
J Pain. 2018 Sep;19(9):1024-1032. doi: 10.1016/j.jpain.2018.03.016. Epub 2018 Apr 12.
Diverse behavioral cues have been proposed to be useful cues in infant pain assessment, but there is a paucity of evidence on the basis of formal psychometric evaluation to establish their validity for this purpose. We aimed to examine 2 widely used coding systems, the Neonatal Facial Coding System (NFCS) and the Modified Behavior Pain Scale (MBPS), by examining their factor structures with confirmatory factor analysis using a large archival data set. The results indicated that an item-reduced NFCS scale with 3 items produced a 1-factor pain model that maintained the good psychometric properties of the 7-item scale. In addition, it was found that MBPS also has challenging internal consistency, with items that are weakly correlated as well as highly redundant. One item of the MBPS may be able to capture the construct of pain equally well or potentially improve its psychometric properties. Redefinition of the MBPS with cry as a sole indicator was suggested. This analysis provides 2 new iterations of the NFCS and MBPS that improve construct validity and internal consistency. These shorter versions also improve the feasibility of both measures and increase their potential for clinical use because less time is required for their administration.
This article presents new iterations of the NFCS and MBPS scales. These revised measures improve the internal consistency of the measures, feasibility of use of the tools in research settings, and the efficiency of the coding process. The revised tools could also improve the feasibility of coding within clinical settings.
已经提出了多种行为线索作为婴儿疼痛评估的有用线索，但缺乏基于正式心理计量评估的证据来确定它们在这方面的有效性。我们旨在通过使用大型档案数据集进行验证性因子分析，检查两个广泛使用的编码系统，即新生儿面部编码系统（NFCS）和改良行为疼痛量表（MBPS）的因子结构。结果表明，具有 3 个项目的简化 NFCS 量表产生了一个 1 因素疼痛模型，保持了 7 个项目量表的良好心理计量特性。此外，还发现 MBPS 的内部一致性也具有挑战性，其项目相关性较弱且高度冗余。MBPS 的一个项目可能同样能够很好地捕捉疼痛的结构，或者可能改善其心理计量特性。建议重新定义仅以哭泣为单一指标的 MBPS。该分析提供了 NFCS 和 MBPS 的 2 个新迭代版本，可提高结构有效性和内部一致性。这些更短的版本还提高了这两种测量方法的可行性，并增加了它们在临床应用中的潜力，因为它们的管理所需时间更少。
本文介绍了 NFCS 和 MBPS 量表的新迭代版本。这些经过修订的措施提高了措施的内部一致性、研究环境中工具使用的可行性以及编码过程的效率。修订后的工具还可以提高在临床环境中进行编码的可行性。
