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Published on: December 20, 2011
Infant behaviors as indicators of established acute pain
1School of Nursing, University of Colorado Health Sciences Center, Denver, USA. barbara.fuller@uchsc.edu
Insights
Infant behaviors like crying may indicate general distress, not just acute pain. Current pain assessment tools may be misleading when evaluating established infant pain.
Area of Science:
- Pediatrics
- Pain Management
- Neonatal Care
Background:
- Infant pain assessment often relies on behavioral cues associated with increased arousal.
- Existing tools were developed based on acute, procedural pain responses.
Purpose of the Study:
- To determine if arousal-based behaviors are valid indicators of established, non-procedural infant pain.
- To assess the suitability of current tools for evaluating established infant pain.
Main Methods:
- Review of research findings on infant behavioral responses to pain.
- Analysis of the specificity of arousal-related behaviors in different pain contexts.
Main Results:
- Behaviors like crying and associated facial expressions are nonspecific indicators of distress.
- These behaviors are not independent indicators of established acute pain.
Conclusions:
- Using arousal-based behaviors to assess established infant pain can be misleading.
- Incorporate behavioral pain responses with clinical data on pain likelihood and consolability for accurate assessment.
Issues And Purpose:
Many infant pain assessment tools use infant behaviors indicative of increased arousal. These tools were developed and tested using clinical situations involving acute immediate pain responses. Are these behaviors valid, clinical indicators of acute established pain (non-procedurally caused) pain? Can these tools be used to assess acute established infant pain? This article explores research findings to answer these questions.
Conclusions:
Findings suggest that behaviors indicative of increased arousal (e.g., crying, facial expressions that accompany crying) are nonspecific indicators of distress rather than independent indicators of established acute pain. Thus, the use of behaviors representing acute immediate pain responses to assess acute established pain, or the use of tools that incorporate these behaviors, can be misleading.
Practice Implications:
Always use acute immediate pain behavioral responses (behaviors indicative of increased arousal) in conjunction with clinical data concerning "likelihood of pain" and consolability.
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