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Updated: Apr 19, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Pain assessment scales in newborns: integrative review]
Gleicia Martins de Melo1, Ana Luíza Paula de Aguiar Lélis1, Alline Falconieri de Moura1
1Universidade Federal do Ceará (UFC), Fortaleza, CE, Brasil.
Insights
This review analyzed 29 newborn pain assessment scales. No single scale is universally best; choose based on infant factors and ensure reliability and validation for accurate pain measurement.
Area of Science:
- Neonatal care
- Pain management
- Clinical assessment tools
Background:
- Effective pain assessment in newborns is crucial for optimal care.
- Numerous pain assessment scales exist, but their appropriateness varies.
- Evidence-based selection of pain assessment tools is essential.
Purpose of the Study:
- To systematically review and analyze existing methods for assessing pain in newborns.
- To identify the range and characteristics of available pain assessment scales.
- To provide guidance on selecting appropriate pain assessment tools for neonates.
Main Methods:
- An integrative review of studies published between 2001 and 2012.
- Searches conducted across major databases: Scopus, PubMed, CINAHL, LILACS, and Cochrane.
- Analysis of 13 articles with Level of Evidence 5.
Main Results:
- A total of 29 distinct pain assessment scales for newborns were identified.
- Scales included 13 one-dimensional and 16 multidimensional instruments.
- These scales assess both acute and prolonged pain in preterm and full-term infants.
Conclusions:
- The selection of a single, universally superior pain assessment scale is not feasible.
- Choice of scale depends on infant's gestational age, the nature of the painful stimulus, and environmental context.
- Recommends using validated and reliable one-dimensional or multidimensional scales for accurate pain assessment.
Objective:
To analyze studies on methods used to assess pain in newborns.
Data Sources:
Integrative review study of articles published from 2001 to 2012, carried out in the following databases: Scopus, PubMed, CINAHL, LILACS and Cochrane. The sample consisted of 13 articles with level of evidence 5.
Data Synthesis:
29 pain assessment scales in newborns, including 13 one-dimensional and 16 multidimensional, that assess acute and prolonged pain in preterm and full-term infants were available in scientific publications.
Conclusion:
Based on the characteristics of scales, one cannot choose a single one as the most appropriate scale, as this choice will depend on gestational age, type of painful stimulus and the environment in which the infant is inserted. It is suggested the use of multidimensional or one-dimensional scales; however, they must be reliable and validated.
