Development and psychometric properties of theSwedishALPS‐Neo pain and stress assessment scale for newborn infants

Abstract

AimTo validate and evaluate the psychometric properties of the ALPS-Neo, a new pain assessment scale created for the continuous evaluation of pain and stress in preterm and sick term infants.MethodsA unidimensional scale for continuous pain, Astrid Lindgren Children's Hospital Pain Scale (ALPS 1), was developed further to assess continuous pain and stress in infants treated in the neonatal intensive care unit (NICU). The pain scale includes observations of five behaviours. A manual was created, clarifying the scoring criteria. An internal and an external panel assessed face validity. Psychometric properties were evaluated in three different steps. Inter-rater reliability was estimated from video-based assessments (n = 625) using weighted kappa statistics (test I). Inter-rater reliability was further evaluated in test II (n = 125) and test III (n = 96) by real-time assessments using the intraclass correlation coefficient (ICC) and Cronbach's alpha.ResultsThe final inter-rater reliability (test III) was assessed as good with ICC 0.91 for the total score and 0.62–0.81 for the five items. Cronbach's alpha showed 0.95 for the total score.ConclusionALPS-Neo is a new assessment tool for optimising the management of pain and stress in newborn infants in the NICU. It has proved easy to implement and user-friendly, permitting fast, reliable observations with high inter-rater reliability.

Music therapy supported the health‐related quality of life for children undergoing haematopoietic stem cell transplants

“…For children 0–17 years of age, the research nurse documented subjectively mood on a five‐point scale: depressed, sad, neutral, positive and happy before and after each music therapy session. For children under the age of four, the Astrid Lindgren Children's Hospital Pain Scale was used . This scale was used in combination with physiological parameters and verbal communication with parents.…”

Pain assessment practices in Swedish and Norwegian neonatal care units

“…The pain measurement scales reported in use differed between the two countries. Different versions of the Astrid Lindgren's Pain Scale (ALPS‐1 (Larsson, BA., unpublished data), ALPS‐0 (Larsson, BA., unpublished data), ALPS‐neo ), were the most frequently used scale in Sweden, while EDIN , ALPS‐1 (unpublished data) and PIPP were the most frequently used scales in Norway. The use of ALPS was higher in Sweden (p = 0.027) and the use of PIPP higher in Norway (p = 0.014).…”

“…Some units reported having more than one scale in use, and eight units did not use any pain measurement scales. ALPS, Astrid Lindgren's Pain Scale [Larsson, unpublished data; Lundqvist et al ], EDIN, Echelle Douleur Inconfort Noveau‐Ne [Debillon et al ]; PIPP, Premature Infant Pain Profile [Stevens et al ]; COMFORT scale [Ambuel et al ]; NIPS, Neonatal Infant Pain Scale [Lawrence et al ]; CRIES, Cries, Requires oxygen, Increased vital signs, Expression, Sleep [Krechel & Bildner ]; N‐PASS, Neonatal Pain, Agitation and Sedation Scale (Hummel et al ); FLACC, Face, Legs, Activity, Cry, Consolability (Merkel et al ).…”

Validity and reliability of ALPS-Neo pain and stress assessment scale in newborns

“…[22] tarafindan 2014'de prematüre ve term yenidoğanlarda ağri ve stresi değerlendirmek amaciyla yenidoğanin bireyselleştirilmiş gelişimsel bakimindan yola çikarak geliştirilmiştir. Literatürde yenidoğanin ağrisini değerlendirmek için pek çok ağri ölçeği bulunmaktadir.…”