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Infant Clinical Pain Assessment: Core Behavioral Cues
Miranda G DiLorenzo1, Rebecca Pillai Riddell2, David B Flora1
1Department of Psychology, York University, Toronto, Ontario, Canada.
The Journal of Pain
|April 16, 2018
Summary
Revised infant pain scales, the Neonatal Facial Coding System (NFCS) and Modified Behavior Pain Scale (MBPS), show improved validity and efficiency for clinical use.
Area of Science:
- Pediatrics
- Pain Assessment
- Psychometrics
Background:
- Infant pain assessment relies on behavioral cues, but formal psychometric validation is lacking.
- Existing tools like the Neonatal Facial Coding System (NFCS) and Modified Behavior Pain Scale (MBPS) require evaluation.
Purpose of the Study:
- To examine the factor structures of the NFCS and MBPS using confirmatory factor analysis.
- To develop psychometrically improved and more feasible versions of these infant pain assessment tools.
Main Methods:
- Confirmatory factor analysis was performed on a large archival dataset.
- Item reduction and redefinition of the NFCS and MBPS were explored.
Main Results:
- A 3-item NFCS demonstrated a 1-factor pain model with good psychometric properties.
- The MBPS exhibited internal consistency challenges; a single item (cry) may suffice.
- New iterations of NFCS and MBPS were developed, enhancing construct validity and internal consistency.
Conclusions:
- Revised NFCS and MBPS offer improved psychometric properties and feasibility for clinical and research settings.
- Shorter versions of these pain assessment tools increase efficiency and potential for wider adoption.
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