Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Nursing School, Zunyi Medical University, Zunyi, China.
Eur J Pediatr. 2024 Sep;183(9):3719-3726. doi: 10.1007/s00431-024-05559-7. Epub 2024 Jun 8.
While over 40 neonatal pain assessment scales have been published, owing to a lack of consensus and standardized metrics, there are more than 100 assessment indicators with varying descriptors and quality differences. This study aims to reach a consensus on optimal and comprehensive variables for neonatal pain assessment, leading to the development of a multidimensional neonatal pain response variable set. This study consisted of three phases: (1) A literature review was conducted to identify influencing factors and assessment indicators of neonatal pain response. (2) Panel meetings involving neonatal healthcare professionals evaluated and screened factors and indicators to develop an initial draft of the variable set. (3) Through two rounds of Delphi study achieved consensus, and determined the neonatal pain response variable set. Through a literature review and a panel meeting, the identified factors and indicators were categorized into contextual, physiological, and behavioral variables, forming an initial draft of the variable set. Sixteen professionals participated in two rounds of the Delphi study, with response rates exceeding 70%, and authority coefficients surpassing 0.7 in both rounds. The final iteration of the variable set includes 9 contextual variables, 2 physiological variables, and 5 behavioral variables. Conclusion: Neonatal pain response variable set developed in this study is scientific, comprehensive, and multidimensional, aligning with the characteristics of neonatal pain response and clinically applicable. The inclusion of contextual variables enhances the ability to confront the complexity of clinical environments and individual differences. It can provide a practical and theoretical basis for clinical research on neonatal pain assessment. What is Known: • Neonatal pain assessment relies on scales used by healthcare professionals currently. But there is no "gold standard" for neonatal pain assessment. • While over 40 neonatal pain assessment scales have been published, owing to a lack of consensus and standardized metrics, there are more than 100 assessment indicators with varying descriptors and quality differences. Most of scales overlook the clinical environment complexity individual differences in pain responses, diminishing the accuracy and applicability. What is New: • In addition to the commonly used physiological and behavioral variables in the scales, we have incorporated contextual variables to better address the complexity of clinical environments and individual differences in pain responses. • Through an evidence-based approach, developed a neonatal pain response variable set comprising 9 contextual variables, 2 physiological variables, and 5 behavioral variables.
虽然已经发表了超过 40 种新生儿疼痛评估量表，但由于缺乏共识和标准化指标，目前有 100 多种评估指标，其描述和质量存在差异。本研究旨在就新生儿疼痛评估的最佳和综合变量达成共识，从而制定多维新生儿疼痛反应变量集。本研究包括三个阶段：（1）进行文献回顾，以确定新生儿疼痛反应的影响因素和评估指标。（2）新生儿保健专业人员小组会议评估和筛选因素和指标，以制定变量集的初始草案。（3）通过两轮德尔菲研究达成共识，确定新生儿疼痛反应变量集。通过文献回顾和小组会议，确定的因素和指标被分为情境、生理和行为变量，形成变量集的初始草案。16 名专业人员参加了两轮德尔菲研究，两轮的回复率均超过 70%，两轮的权威系数均超过 0.7。变量集的最终迭代包括 9 个情境变量、2 个生理变量和 5 个行为变量。结论：本研究制定的新生儿疼痛反应变量集具有科学性、全面性和多维性，符合新生儿疼痛反应的特点和临床适用性。纳入情境变量增强了应对临床环境复杂性和个体差异的能力。可为临床新生儿疼痛评估研究提供实用和理论基础。已知：• 目前，新生儿疼痛评估依赖于医护人员使用的量表。但是，新生儿疼痛评估还没有“金标准”。• 虽然已经发表了超过 40 种新生儿疼痛评估量表，但由于缺乏共识和标准化指标，目前有 100 多种评估指标，其描述和质量存在差异。大多数量表忽略了临床环境的复杂性和疼痛反应的个体差异，降低了准确性和适用性。新发现：• 除了量表中常用的生理和行为变量外，我们还纳入了情境变量，以更好地应对临床环境的复杂性和疼痛反应的个体差异。• 通过循证方法，制定了一个包含 9 个情境变量、2 个生理变量和 5 个行为变量的新生儿疼痛反应变量集。
