Sharyn Gibbins1, Bonnie J Stevens2, Janet Yamada3, Kimberley Dionne3, Marsha Campbell-Yeo4, Grace Lee2, Kim Caddell5, Céleste Johnston6, Anna Taddio2. 1. Trillium Health Partners, Mississauga, Ontario, Canada; The University of Toronto, Toronto, Ontario, Canada. Electronic address: sgibbins@cvh.on.ca. 2. The University of Toronto, Toronto, Ontario, Canada; The Hospital for Sick Children, Toronto, Ontario, Canada. 3. The Hospital for Sick Children, Toronto, Ontario, Canada. 4. IWK Health Centre, Halifax, Nova Scotia, Canada; Dalhousie University, Halifax, Nova Scotia, Canada. 5. IWK Health Centre, Halifax, Nova Scotia, Canada. 6. IWK Health Centre, Halifax, Nova Scotia, Canada; McGill University, Montréal, Québec, Canada.
Abstract
OBJECTIVES: To examine the construct validity, inter-rater reliability, and feasibility of the Premature Infant Pain Profile-Revised in infants of varying gestational ages, diagnoses, and procedures. METHODS: A prospective cross-over study with infants in three gestational age groups (26-31, 32-36, and ≥37 weeks) at three university-affiliated Neonatal Intensive Care Units in Canada. One hundred and ninety five bedside nurses and expert raters rated 202 hospitalized infants' pain during scheduled procedures using the measure. An expert rater and a nurse independently assessed infants' pain scores, using the Premature Infant Pain Profile-Revised, during 246 scheduled pairs of painful and non-painful procedures in the 202 infants. Nurses also completed a feasibility survey on using the measure in a clinical setting. To establish construct validity, pain scores were computed during painful and non-painful procedures. Inter-rater reliability between pain experts and nurses was calculated. A 5-point Likert scale was used to measure feasibility in terms of clarity, ease of use, and time to complete. RESULTS: Irrespective of gestational age, Premature Infant Pain Profile-Revised scores were significantly higher during painful procedures (mean 6.7 [SD 3.0]) compared to non-painful procedures (mean 4.8 [SD 2.9]). There was a high degree of correlation between nurses' and experts' ratings for painful (all R(2)=0.92, p<0.001) and non-painful (all R(2)=0.87, p<0.001) procedures. Mean scores on all feasibility indicators were equal to or higher than 3.8. DISCUSSION: The Premature Infant Pain Profile Revised has beginning construct validation, inter-rater reliability, and is considered feasible by clinicians. Concurrent validation studies should be considered.
OBJECTIVES: To examine the construct validity, inter-rater reliability, and feasibility of the Premature InfantPain Profile-Revised in infants of varying gestational ages, diagnoses, and procedures. METHODS: A prospective cross-over study with infants in three gestational age groups (26-31, 32-36, and ≥37 weeks) at three university-affiliated Neonatal Intensive Care Units in Canada. One hundred and ninety five bedside nurses and expert raters rated 202 hospitalized infants' pain during scheduled procedures using the measure. An expert rater and a nurse independently assessed infants' pain scores, using the Premature InfantPain Profile-Revised, during 246 scheduled pairs of painful and non-painful procedures in the 202 infants. Nurses also completed a feasibility survey on using the measure in a clinical setting. To establish construct validity, pain scores were computed during painful and non-painful procedures. Inter-rater reliability between pain experts and nurses was calculated. A 5-point Likert scale was used to measure feasibility in terms of clarity, ease of use, and time to complete. RESULTS: Irrespective of gestational age, Premature InfantPain Profile-Revised scores were significantly higher during painful procedures (mean 6.7 [SD 3.0]) compared to non-painful procedures (mean 4.8 [SD 2.9]). There was a high degree of correlation between nurses' and experts' ratings for painful (all R(2)=0.92, p<0.001) and non-painful (all R(2)=0.87, p<0.001) procedures. Mean scores on all feasibility indicators were equal to or higher than 3.8. DISCUSSION: The Premature InfantPain Profile Revised has beginning construct validation, inter-rater reliability, and is considered feasible by clinicians. Concurrent validation studies should be considered.
Authors: Kanecia O Zimmerman; Christoph P Hornik; Lawrence Ku; Kevin Watt; Matthew M Laughon; Margarita Bidegain; Reese H Clark; P Brian Smith Journal: J Pediatr Date: 2015-05-23 Impact factor: 6.314