Fuller B F, Conner D A
Clin Nurs Res. 1995 Aug;4(3):253-73. doi: 10.1177/105477389500400304.
Facial, body, and cry behaviors, heart rate, palmar sweating, and acoustic cry measures were compared across differing levels of infant pain. Eighty-eight infants were placed in a 16-cell matrix of 4 ages (0 to 3 mo., 4 to 6 mo., 7 to 9 mo., and 10 to 12 mo.) and levels of pain (LOP) (none, mild, moderate, severe) with 5 to 6 infants occupying each cell. Matrix placement was determined by agreement of > 75% among five pediatric clinical nurse specialists who viewed videotapes and read information about the infant's history, diagnosis, medical and/or surgical status, medications, and nutritional/fluid status. Coded infant behaviors and acoustic cry parameters were compared using a 2-level (LOP, age) MANOVA. Behaviors that differed across LOP were influenced by infant development. Facial expressions were clinically useful LOP indicators only for 0- to 3-month-old infants. Facial and body behaviors and cry measures that differed across LOP in younger infants did not differ in older infants due to the development of intentionality. Cry orientation and consolability may be useful clinical indicators of pain with older infants.
研究人员比较了不同程度婴儿疼痛下的面部、身体和哭声行为、心率、手掌出汗情况以及哭声声学指标。88名婴儿被安排在一个16格矩阵中，该矩阵考虑了4个年龄段（0至3个月、4至6个月、7至9个月、10至12个月）和疼痛程度（无疼痛、轻度疼痛、中度疼痛、重度疼痛），每个格子中有5至6名婴儿。矩阵安排由五名儿科临床护士专家确定，他们观看录像带并阅读有关婴儿病史、诊断、医疗和/或手术状况、用药情况以及营养/液体状况的信息，超过75%的专家达成一致意见。使用两级（疼痛程度、年龄）多变量方差分析（MANOVA）比较编码后的婴儿行为和哭声声学参数。不同疼痛程度下存在差异的行为受婴儿发育的影响。面部表情仅对0至3个月大的婴儿是临床上有用的疼痛程度指标。由于意向性的发展，年龄较小婴儿中不同疼痛程度下存在差异的面部和身体行为及哭声指标在年龄较大婴儿中并无差异。哭声指向性和可安抚性可能是年龄较大婴儿疼痛的有用临床指标。
