Nurses' judgments of pain in term and preterm newborns.

OBJECTIVE

To examine neonatal intensive-care unit nurses' judgments of pain intensity in term and preterm newborns and to describe the cues used to assess the possible presence of pain in newborns.

DESIGN

A combination of quantitative and qualitative approaches that included both parametric and nonparametric statistical procedures and a content analysis.

SETTING

A large, university-affiliated, tertiary-care hospital in central Canada.

PARTICIPANTS

Forty-five registered nurses employed in the neonatal intensive-care unit.

INTERVENTIONS

Nurses viewed videotapes of term and preterm newborns and written vignettes. Visual analogue scales and open-ended questions were used.

MAIN OUTCOME MEASURES

Pain intensity ratings of full-term and preterm newborns and the cues identified as indicative of pain in newborns.

RESULTS

Nurses gave significantly higher pain intensity ratings to the full-term group than to the preterm group of newborns. Some differences were found in the cues identified by the nurses in assessing pain in term versus preterm newborns.

CONCLUSIONS

Nurses' judgments of pain intensity in newborns are influenced by the vigor and richness of the newborn's behavior response. Neonatal nurses must be provided with continuing education that focuses upon recognition of the signs and symptoms of pain in newborns.