Individual contextual factors in the validation of the Bernese pain scale for neonates: protocol for a prospective observational study

Cignacco, Eva; Schenk, Karin; Stevens, Bonnie; Stoffel, Liliane; Bassler, Dirk; Schulzke, Sven; Nelle, Mathias

doi:10.1186/s12887-017-0914-9

Cited by 13 publications

(13 citation statements)

References 68 publications

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“…Crying is a common pain response in neonates and is included in several pain scales (e.g., [27, 61–63]), but some have questioned crying as an indicator of pain because it cannot be assessed in some neonates [21, 59]. Mechanical ventilation, inhibiting drugs, severe illness, and other reasons may limit the ability to cry.…”

Section: Discussionmentioning

confidence: 99%

“…Neonates were recruited by consecutive sampling and then stratified according to GA at birth [27]. Trained study assistants in each study centre identified potentially eligible neonates and informed their parents of the aim and purpose of the study.…”

Section: Methodsmentioning

confidence: 99%

“…We retrieved individual contextual factors retrospectively from patient charts [27] and will publish a separate paper describing their influence on the variability of pain reaction across repeated measurement points.…”

Section: Methodsmentioning

confidence: 99%

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The influence of gestational age in the psychometric testing of the Bernese Pain Scale for Neonates

et al. 2019

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BackgroundAssessing pain in neonates is challenging because full-term and preterm neonates of different gestational ages (GAs) have widely varied reactions to pain. We validated the Bernese Pain Scale for Neonates (BPSN) by testing its use among a large sample of neonates that represented all GAs.MethodsIn this prospective multisite validation study, we assessed 154 neonates between 24 2/7 and 41 4/7 weeks GA, based on the results of 1–5 capillary heel sticks in their first 14 days of life. From each heel stick, we produced three video sequences: baseline; heel stick; and, recovery. Five blinded nurses rated neonates’ pain responses according to the BPSN. The underlying factor structure of the BPSN, interrater reliability, concurrent validity with the Premature Infant Pain Profile-Revised (PIPP-R), construct validity, sensitivity and specificity, and the relationship between behavioural and physiological indicators were explored. We considered GA and gender as individual contextual factors.ResultsThe factor analyses resulted in a model where the following behaviours best fit the data: crying; facial expression; and, posture. Pain scores for these behavioural items increased on average more than 1 point during the heel stick phases compared to the baseline and recovery phases (p < 0.001). Among physiological items, heart rate was more sensitive to pain than oxygen saturation. Heart rate averaged 0.646 points higher during the heel stick than the recovery phases (p < 0.001). GA increased along with pain scores: for every additional week of gestation, the average increase of behavioural pain score was 0.063 points (SE = 0.01, t = 5.49); average heart rate increased 0.042 points (SE = 0.01, t = 6.15). Sensitivity and specificity analyses indicated that the cut-off should increase with GA. Modified BPSN showed good concurrent validity with the PIPP-R (r = 0.600–0.758, p < 0.001). Correlations between the modified behavioural subscale and the item heart rate were low (r = 0.102–0.379).ConclusionsThe modified BPSN that includes facial expression, crying, posture, and heart rate is a reliable and valid tool for assessing acute pain in full-term and preterm neonates, but our results suggest that adding different cut-off points for different GA-groups will improve the BPSN’s clinical usefulness.Trial registrationThe study was retrospectively registered in the database of Clinical Trial gov. Study ID-number: NCT 02749461. Registration date: 12 April 2016.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The influence of gestational age in the psychometric testing of the Bernese Pain Scale for Neonates

et al. 2019

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“…Swaddling/tucking was found to be effective in reducing pain in premature infants (5). In recent years, a series of observational tools have been developed to measure stress and pain (6,7). The comfort scale which is well-known multidimensional tool, is originally developed as a continuous measure of distress, sedation and pain in nonverbal pediatric patients aged from birth to 18 years (8,9).…”

Section: Introductionmentioning

confidence: 99%

Destekleyici Konumlandırmanın Preterm Yenidoğanlarda COMFORT Ölçek Puanlarına Etkisi

Yapıcıoğlu¹,

Barutçu²,

Gülcü³

et al. 2021

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Aim: Premature babies are vulnerable to environmental stress factors mostly in the first weeks of life. During this time, supportive positioning, especially used all-around the baby, makes them feel better as if they are in utero. The aim of the study was to evaluate the effect of supportive positioning on weight gain, vital signs, feeding intolerance, duration of ventilation, duration of hospitalization and comfort scale scores of the premature babies in neonatal intensive care unit. Material and Methods: A total of 50 premature infants were recruited into the study randomly, 25 in the supported group and 25 in the control group. The babies in the supported group were nested with soft blankets and pillows as position material. There was no nesting or swaddling in the control group. Demographic findings, comfort scale scores, heart rate, respiratory rate and oxygen saturation of infants were recorded and compared. Results: Mean gestational weeks and birth weights of the supported and control groups were 32.9±2.5 (26-36) vs. 32.7±2.8 (26-36) weeks (p=0.791) and 1554±492 (680-2380) vs. 1772±439 (590-2375) g (p=0.105), respectively. Weight gain, ventilator days and days of hospitalization were similar in groups, however mean oxygen saturation and comfort scale scores showing deep sedation were higher in the supported group (p=0,024, p<0,001, respectively) after daily care. Conclusion: Although supportive positioning does not have an effect on duration of hospitalization, ventilation and weight gain, it has a positive effect on mean oxygen saturation and comfort scale scores of premature infants and recommended in newborn care.

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“…A dor gera desconforto, estresse e irritabilidade especialmente em unidades de internação neonatal. Os fatores contextuais a dor do neonato englobam: maturidade, estado de saúde, ambiente, equipe que presta cuidados, além de experiência anterior com a dor ou a duração da hospitalização (MELO; CARDOSO, 2017;CIGNACCO et al, 2017).…”

Section: Introducãounclassified

A enfermagem a partir de uma visão crítica: Excelência das práticas de cuidado 3

Frias¹

2021

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Individual contextual factors in the validation of the Bernese pain scale for neonates: protocol for a prospective observational study

Cited by 13 publications

References 68 publications

The influence of gestational age in the psychometric testing of the Bernese Pain Scale for Neonates

The influence of gestational age in the psychometric testing of the Bernese Pain Scale for Neonates

Destekleyici Konumlandırmanın Preterm Yenidoğanlarda COMFORT Ölçek Puanlarına Etkisi

A enfermagem a partir de uma visão crítica: Excelência das práticas de cuidado 3

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