Parallel assessment of prolonged neonatal distress by empathy-based and item-based scales

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• 作者：Lars Garten ; Philipp Deindl ; Gerd Schmalisch ; Boris Metze ; Christoph Bü ; hrer
• 关键词：Newborn ; Infant ; Preterm ; N-PASS ; Faces Pain Scale-Revised
• 刊名：European Journal of Pain
• 出版年：2010
• 出版时间：September 2010
• 年：2010
• 卷：14
• 期：8
• 页码：878-881
• 全文大小：711 K

文摘

Objective

To evaluate the association between the empathy-based Faces Pain Scale-Revised (FPS-R) and the item-based Neonatal Pain, Agitation and Sedation Scale (N-PASS) when used to assess prolonged distress in term and preterm infants.

Method

Sequential prospective psychometric evaluations of distress, at 4-h intervals during a 48-h time period. FPS-R and N-PASS were employed in parallel by the nurses in charge in 44 term and preterm newborn infants.

Results

During the overall 48-h observation period, median FPS-R declined from 6/10 to 2/10 (p < 0.001) while N-PASS did not change significantly. FPS-R and N-PASS showed strong correlation during the first 12 h of observation (R_s = 0.786, p < 0.001). During each of the following 12-h observation periods, the strength of this association decreased (12–24 h: R_s = 0.781; 24–36 h: R_s = 0.675; 36–48 h: R_s = 0.658) while remaining significant (p < 0.001). However, when used to categorize infants as being in distress or not, the rate of agreement between FPS-R and N-PASS showed little variation (0–12 h: 79.6 % , 12–24 h: 88.6 % ; 24–36 h: 89.4 % , 36–48 h: 84.9 % ).

Conclusions

In newborn infants serially assessed over 48 h, there is a progressive divergence between FPS-R and N-PASS. There is, however, reason to extend the use of the FPS-R also to the neonatal arena, as the rate of agreement between N-PASS and FPS-R to categorize an infant as being in distress or not remains stable. Preference of item- or empathy-based assessment may be a question of personal philosophy rather than medical science.