RT Journal Article
SR Electronic
T1 Validation of a neonatal pain scale adapted to the new practices in caring for preterm newborns
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F263
OP F266
DO 10.1136/adc.2008.144758
VO 95
IS 4
A1 Milesi, Christophe
A1 Cambonie, Gilles
A1 Jacquot, Aurelien
A1 Barbotte, Eric
A1 Mesnage, Renaud
A1 Masson, Florence
A1 Pidoux, Odile
A1 Ferragu, Felicie
A1 Thevenot, Pierre
A1 Mariette, Jean-Bernard
A1 Picaud, Jean-Charles
YR 2010
UL http://fn.bmj.com/content/95/4/F263.abstract
AB Background Neonatal pain assessment generally requires access to facial expression. Improved neonatology practices, such as greater protection against bright lights and non-invasive mask ventilation, have made facial observation more difficult. Objective To validate a ‘faceless’ acute neonatal pain scale (FANS), which does not depend on facial expression. Methods In a prospective, multicentre study, 24–40-week-old neonates were videotaped during a painful procedure (heel prick). Three investigators then scored the pain using FANS and a previously validated scale: DAN (Douleur aiguë du Nouveau-né). FANS is based on assessment of limb movement, cry and autonomic reaction. Reliability was assessed by inter-rater agreement and internal consistency (Cronbach's α). Validity was evaluated by agreement between scales (intraclass correlation coefficient (ICC)). The Wilcoxon test evaluated the FANS score differences between conditions. Results are expressed as medians (25th and 75th percentiles). Ranges are presented for outcome parameters. Results From April 2006 to September 2007, 53 preterms of 32 (30–35) gestational weeks and 1500 (1000–2200) g were observed. Cronbach's α was 0.72. The ICC was 0.92 (0.9–0.98) for inter-rater agreement and 0.88 (0.76–0.93) for agreement between scales. Conclusion FANS, which is reliable and valid, is the first scale to score pain in preterm newborns when facial expression is not accessible.