Article Text

VALIDATION FOR A SCALE ASSESSING NEONATAL PAIN FITTING THE PREVAILING CONDITIONS OF NEONATAL CARE
  1. C Milesi1,
  2. G Cambonie1,
  3. A Jacquot1,
  4. E Barbotte4,
  5. F Ferragu1,
  6. R Mesnage1,
  7. F Masson1,
  8. O Pidoux1,
  9. O Plan1,
  10. M Badr1,
  11. C Bouchbacher1,
  12. P Fournier1,
  13. J B Mariette2,
  14. P Thevenot3,
  15. J C Picaud1
  1. 1Réanimation Pédiatrique, CHU Arnaud de Villeneuve, Montpellier, France
  2. 2Réanimation Néonatale, CHU Caremau, Nimes, France
  3. 3Réanimation Néonatale, CH Perpignan, Perpignan, France
  4. 4Département Informatique Médicale, CHU Arnaud de Villeneuve, Montpellier, France

Abstract

Introduction All newborn acute pain scores require face observation. Using linen protecting from light aggressiveness as well as non-invasive ventilation masks make the face less accessible. The point is to validate FANS scale (Faceless Acute Pain Neonatal Scale) ignoring face survey.

Methodology Prospective multi-centric study. We filmed premature babies (24–40 weeks of gestation) during a painful care (venipuncture). Three observers assessed pain with FANS and a validated score: DAN (Acute Pain of Neonate). The FANS based on movements, screaming and vegetative reactions survey. Reliability study included: inter-observers agreement and internal consistency (Cronbach alpha coefficient). Validity study included: intraclass correlation coefficient (ICC) between the 2 scales. To assess the discriminating ability towards painful and non-painful stimulation, 10 patients were observed (watched ? surveyed ?) during thigh rubbing and during puncture. FANS’score difference between the two situations were studied according to Wilcoxon test.

Results From April 2006 to September 2007, 53 prematures 32 [30–35] weeks and 1500 [1000–2200] g. were observed (watched?). Cronbach alpha coefficient is 0.72. ICC were 0.92 [0.9–0.98] for inter-observer agreement and 0.88 [0.76–0.93] for scales correlation. The scores are significantly higher during the painful events/non painful stimulation: (3 [2–5] vs 1 [0–1], p<0.003).

Conclusion FANS scale seems reliable and valid. It is the very first scale to assess pain when face is inaccessible to survey.

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