Pillai Riddell Rebecca, Gennis Hannah, Tablon Paula, Greenberg Saul, Garfield Hartley
Psychology, Faculty of Health, York University, Toronto, Ontario, Canada.
Psychiatry Research, The Hospital for Sick Children, Toronto, Ontario, Canada.
Can J Pain. 2018 Jun 14;2(1):135-144. doi: 10.1080/24740527.2018.1471325. eCollection 2018.
Infants rely on their parents' sensitive and contingent soothing to support their regulation from pain-related distress. However, despite being of potentially equal or greater import, there has been little focus on how to measure distress-promoting parent behaviors.
The goal of this article was to develop and validate a measure of distress-promoting parent behaviors for acute painful procedures (e.g., vaccinations) that could be used by researchers and clinicians.
Following initial generation of measure items, focused group discussions were held with vaccinating clinicians to understand the measure's face, content, and ecological validity. Archival video footage ( = 537 videos of infant-caregiver dyads during vaccination) was then coded using the measure of distress-promoting behaviors for 3 minutes post vaccine injection. Validity and reliability were examined using correlational analyses. Construct validity was assessed by convergent relationships with infant pain-related distress and divergent relationships were assessed with parent sensitivity and soothing-promoting behaviors.
The measure demonstrated both moderate to excellent interrater and test-retest reliability and convergent and divergent validity (absolute magnitude of 's = 0.30 to 0.46).
By demonstrating strong reliability and validity, this measure represents a promising new way to understand how caregivers interact with infants during painful procedures. Through focusing on distress promotion and using a format that may be coded both from video or in vivo, it is a feasible way to operationalize the impact of the caregiver on the infant's pain experience in both research and clinical settings.
婴儿依靠父母敏感且适时的安抚来帮助他们调节与疼痛相关的痛苦情绪。然而，尽管这可能具有同等重要甚至更重要的意义，但对于如何测量会加剧痛苦的父母行为却鲜有关注。
本文的目的是开发并验证一种用于急性疼痛程序（如疫苗接种）中会加剧痛苦的父母行为的测量方法，供研究人员和临床医生使用。
在初步生成测量项目后，与进行疫苗接种的临床医生进行了焦点小组讨论，以了解该测量方法的表面效度、内容效度和生态效度。然后，使用疫苗注射后3分钟内加剧痛苦行为的测量方法，对存档视频资料（n = 537段婴儿-照顾者二元组在疫苗接种期间的视频）进行编码。使用相关分析来检验效度和信度。通过与婴儿疼痛相关痛苦的收敛关系评估结构效度，通过与父母敏感性和促进安抚行为的发散关系评估发散效度。
该测量方法显示出中等至优秀的评分者间信度和重测信度以及收敛效度和发散效度（r值的绝对值 = 0.30至0.46）。
通过证明强大的信度和效度，该测量方法代表了一种有前景的新方式，用于理解照顾者在痛苦程序中如何与婴儿互动。通过关注痛苦加剧情况并采用一种既可以从视频中也可以在实际场景中进行编码的形式，它是一种在研究和临床环境中衡量照顾者对婴儿疼痛体验影响的可行方法。
