医学
奇纳
社会心理的
梅德林
可靠性(半导体)
系统回顾
人口
疼痛评估
标准效度
有效性
科克伦图书馆
心理测量学
结构效度
物理疗法
置信区间
临床心理学
心理干预
疼痛管理
精神科
内科学
法学
功率(物理)
物理
环境卫生
量子力学
政治学
作者
Lenora Duhn,Jennifer Medves
标识
DOI:10.1016/j.adnc.2004.04.005
摘要
PURPOSE To examine the issue of pain assessment in infants by acquiring all available published pain assessment tools and evaluating their reported reliability, validity, clinical utility, and feasibility. DESIGN AND METHODS A systematic integrative review of the literature was conducted using the following databases: MEDLINE and CINAHL (through February 2004), and Health and Psychosocial Instruments, and Cochrane Systematic Reviews (through 2003). MeSH headings searched included "pain measurement," with limit of "newborn infant"; "infant newborn"; and "pain perception." SUBJECTS Thirty-five neonatal pain assessment tools were found and evaluated using predetermined criteria. The critique consisted of a structured comparison of the classification and dimensions measured. Further, the population tested and reports of reliability, validity, clinical utility, and feasibility were reviewed. RESULTS Of the 35 measures reviewed, 18 were unidimensional and 17 were multidimensional. Six of the multidimensional measures were published as abstracts only, were not published at all, or the original work could not be obtained. None of the existing instruments fulfilled all criteria for an ideal measure; many require further psychometric testing. CONCLUSIONS When choosing a pain assessment tool, one must also consider the infant population and setting, and the type of pain experienced. The decision should be made after carefully considering the existing published options. Confidence that the instrument will assess pain in a reproducible way is essential, and must be demonstrated with validity and reliability testing. Using an untested instrument is not recommended, and should only occur within a research protocol, with appropriate ethics and parental approval. Because pain is a multidimensional phenomenon, well-tested multidimensional instruments may be preferable.
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