Agreement of Revised Premature Infant Pain Profile Scoring between Healthcare Providers and Laypersons: A Cross-sectional Study
Introduction: The experience of pain during the neonatal period has short and long-term consequences. The Revised Premature Infant Pain Profile (PIPP-R) is a globally accepted and validated tool for assessing pain in neonates. Adequate pain management measures can be implemented using the PIPP-R...
Main Authors: | , , , , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2023-11-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://www.jcdr.net/articles/PDF/18652/63552_CE[Ra1]_F(IS)_QC(SD_RDW_SS)_PF1(HB_OM)_PFA(HB_KM)_PN(KM).pdf |
Summary: | Introduction: The experience of pain during the neonatal period
has short and long-term consequences. The Revised Premature
Infant Pain Profile (PIPP-R) is a globally accepted and validated
tool for assessing pain in neonates. Adequate pain management
measures can be implemented using the PIPP-R, even in the
absence of consultants.
Aim: To assess the agreement among healthcare providers and
laypersons in scoring the PIPP-R.
Materials and Methods: A cross-sectional study was
conducted at Shree Krishna Hospital, a rural Tertiary Care
Teaching Hospital in central Gujarat, India. The duration of the
study was one year and six months, from January 2021 to June
2022. The study included 12 volunteers from various fields,
such as consultant neonatologists, first year postgraduate
students in Department of Paediatrics, neonatal nurses, social
workers, Bachelor of Medicine, Bachelor of Surgery (MBBS)
interns, and mothers of newborns. A neonatology consultant
provided training on the PIPP-R scoring system using
handouts and a presentation. The volunteers then evaluated
100 prerecorded videos of newborns undergoing painful
procedures. Agreement between volunteers for the total
PIPP-R score and its subcomponents was assessed using
Bland-Altman analysis and Cohen’s Kappa statistics.
Results: A total of 100 videos of newborns (51 girls, 49 boys)
undergoing painful procedures were evaluated for the PIPP-R
score. The mean age, gestational age, and birth weight of the
newborns were 2.21±1.55 days, 37±2.44 weeks, and 2.56±0.72
kg, respectively. The procedures included heel prick for Random
Blood Sugar (RBS) (44%), intravenous sampling/insertion (34%),
and intramuscular vitamin K injection (22%). The mean difference
with 95% Confidence Limits (CL) of total PIPP-R scores between
the two consultants (neonatologists) was -0.640 (-5.196, 3.916).
The length of the CL was -9.112, which fell outside the defined
CL of 4.2 (20% of the total score), indicating unacceptable
agreement between the two consultants. Similarly, agreement
between each consultant and any of the other participants,
including residents, nurses, interns, mothers, and social workers,
regarding the total PIPP-R score, as well as its subcomponents,
was also deemed unacceptable.
Conclusion: The present study concluded that the inter-rater
reliability of the PIPP-R score and its subcomponents was
unacceptable between consultants and with any of the other
participants. |
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ISSN: | 2249-782X 0973-709X |