Reliability of two behavioral tools to assess pain in preterm neonates
CONTEXT: One of the main difficulties in adequately treating the pain of neonatal patients is the scarcity of validated pain evaluation methods for this population. OBJECTIVE: To analyze the reliability of two behavioral pain scales in neonates. TYPE OF STUDY: Cross-sectional. SETTING: University ho...
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| Format: | Article |
| Language: | English |
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Associação Paulista de Medicina
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| Series: | São Paulo Medical Journal |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802003000200008&lng=en&tlng=en |
| _version_ | 1818027324345417728 |
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| author | Ruth Guinsburg Maria Fernanda Branco de Almeida Clóvis de Araújo Peres Alexandre R. Shinzato Benjamin Israel Kopelman |
| author_facet | Ruth Guinsburg Maria Fernanda Branco de Almeida Clóvis de Araújo Peres Alexandre R. Shinzato Benjamin Israel Kopelman |
| author_sort | Ruth Guinsburg |
| collection | DOAJ |
| description | CONTEXT: One of the main difficulties in adequately treating the pain of neonatal patients is the scarcity of validated pain evaluation methods for this population. OBJECTIVE: To analyze the reliability of two behavioral pain scales in neonates. TYPE OF STUDY: Cross-sectional. SETTING: University hospital neonatal intensive care unit. PARTICIPANTS: 22 preterm neonates were studied, with gestational age of 34 ± 2 weeks, birth weight of 1804 ± 584 g, 68% female, 30 ± 12 hours of life, and 30% intubated. PROCEDURES: Two neonatologists (A and B) observed the patients at the bedside and on video films for 10 minutes. The Neonatal Facial Coding System and the Clinical Scoring System were scored at 1, 5, and 10 minutes. The final score was the median of the three values for each observer and scale. A and B were blinded to each other. Video assessments were made three months after bedside evaluations. MAIN MEASUREMENTS: End scores were compared between the observers using the intraclass correlation coefficient and bias analysis (paired t test and signal test). RESULTS: For the Neonatal Facial Coding System, at the bedside and on video, A and B showed a significant correlation of scores (intraclass correlation score: 0.62), without bias between them (t test and signal test: p > 0.05). For the Clinical Scoring System bedside assessment, A and B showed correlation of scores (intraclass correlation score: 0.55), but bias was also detected between them: A scored on average two points higher than B (paired t test and signal test: p < 0.05). For the Clinical Scoring System video assessment, A and B did not show correlation of scores (intraclass correlation score: 0.25), and bias was also detected between them (paired t-test and signal test: p < 0.05). CONCLUSION: The results strengthen the reliability of the Neonatal Facial Coding System for bedside pain assessment in preterm neonates. |
| first_indexed | 2024-12-10T04:46:05Z |
| format | Article |
| id | doaj.art-ecb059e7ddc743c4908a94e56a0ed3ca |
| institution | Directory Open Access Journal |
| issn | 1806-9460 |
| language | English |
| last_indexed | 2024-12-10T04:46:05Z |
| publisher | Associação Paulista de Medicina |
| record_format | Article |
| series | São Paulo Medical Journal |
| spelling | doaj.art-ecb059e7ddc743c4908a94e56a0ed3ca2022-12-22T02:01:45ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-94601212727610.1590/S1516-31802003000200008S1516-31802003000200008Reliability of two behavioral tools to assess pain in preterm neonatesRuth Guinsburg0Maria Fernanda Branco de Almeida1Clóvis de Araújo Peres2Alexandre R. Shinzato3Benjamin Israel Kopelman4Universidade Federal de São PauloUniversidade Federal de São PauloUniversidade Federal de São PauloUniversidade Federal de São PauloUniversidade Federal de São PauloCONTEXT: One of the main difficulties in adequately treating the pain of neonatal patients is the scarcity of validated pain evaluation methods for this population. OBJECTIVE: To analyze the reliability of two behavioral pain scales in neonates. TYPE OF STUDY: Cross-sectional. SETTING: University hospital neonatal intensive care unit. PARTICIPANTS: 22 preterm neonates were studied, with gestational age of 34 ± 2 weeks, birth weight of 1804 ± 584 g, 68% female, 30 ± 12 hours of life, and 30% intubated. PROCEDURES: Two neonatologists (A and B) observed the patients at the bedside and on video films for 10 minutes. The Neonatal Facial Coding System and the Clinical Scoring System were scored at 1, 5, and 10 minutes. The final score was the median of the three values for each observer and scale. A and B were blinded to each other. Video assessments were made three months after bedside evaluations. MAIN MEASUREMENTS: End scores were compared between the observers using the intraclass correlation coefficient and bias analysis (paired t test and signal test). RESULTS: For the Neonatal Facial Coding System, at the bedside and on video, A and B showed a significant correlation of scores (intraclass correlation score: 0.62), without bias between them (t test and signal test: p > 0.05). For the Clinical Scoring System bedside assessment, A and B showed correlation of scores (intraclass correlation score: 0.55), but bias was also detected between them: A scored on average two points higher than B (paired t test and signal test: p < 0.05). For the Clinical Scoring System video assessment, A and B did not show correlation of scores (intraclass correlation score: 0.25), and bias was also detected between them (paired t-test and signal test: p < 0.05). CONCLUSION: The results strengthen the reliability of the Neonatal Facial Coding System for bedside pain assessment in preterm neonates.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802003000200008&lng=en&tlng=enPainNewbornInfantAssessment |
| spellingShingle | Ruth Guinsburg Maria Fernanda Branco de Almeida Clóvis de Araújo Peres Alexandre R. Shinzato Benjamin Israel Kopelman Reliability of two behavioral tools to assess pain in preterm neonates São Paulo Medical Journal Pain Newborn Infant Assessment |
| title | Reliability of two behavioral tools to assess pain in preterm neonates |
| title_full | Reliability of two behavioral tools to assess pain in preterm neonates |
| title_fullStr | Reliability of two behavioral tools to assess pain in preterm neonates |
| title_full_unstemmed | Reliability of two behavioral tools to assess pain in preterm neonates |
| title_short | Reliability of two behavioral tools to assess pain in preterm neonates |
| title_sort | reliability of two behavioral tools to assess pain in preterm neonates |
| topic | Pain Newborn Infant Assessment |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802003000200008&lng=en&tlng=en |
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