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Published on: November 29, 2017
Pain assessment in the neonate using the Bernese Pain Scale for Neonates
Eva Cignacco1, Romano Mueller, Jan P H Hamers
1Department of Obstretics and Neonatology, University Hospital, Inselspital, Effingerstreet 102, CH-3010 Berne, Switzerland. eva.cignacco@insel.ch
Background:
Neonates who require treatment in the neonatal intensive care unit (NICU) are subjected to many invasive painful procedures.
Aims:
Assessment of pain in preterm and term neonates with or without ventilation on continuous positive airway pressure using the Bernese Pain-Scale for Neonates (BPSN). The validity and the reliability of the BPSN was established.
Study Design And Subjects:
Pain assessments (n=288) were performed by 6 health care workers in different situations of term and preterm neonates. Each neonate (n=12) was observed in four given situations (after feeding, while a foot was being warmed, while a routine capillary blood sample was taken and 15 min after the blood sample was taken). Pain assessments were made by two nurses at the bedside using the BPSN, the Visual-Analogue Scale (VAS) and the Premature Infant Pain Profile (PIPP). At the same time, a video sequence was made which was shown later to four different nurses to assess pain using the BPSN, the PIPP, and the VAS.
Results:
The construct validity of the BPSN was very good (F=41.3, p<0.0001). Moreover, concurrent and convergent validity of the BPSN compared to VAS and PIPP was r=0.86, and r=0.91, p<0.0001, respectively. Finally, the study demonstrated high coefficients for interrater (r=0.86-0.97) and intrarater reliability (r=0.98-0.99).
Conclusion:
The BPSN was shown to be a valid and reliable tool for assessing pain in term and preterm neonates with and without ventilation.
