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Título: Identification of pain indicators for infants at risk for neurological impairment: A Delphi consensus study
Autores: Stevens, Bonnie
McGrath, Patrick
Yamada, Janet
Gibbins, Sharyn
Beyene, Joseph
Breau, Lynn
Camfield, Carol
Finley, Allen
Franck, Linda
Howlett, Alexandra
Johnston, Celeste
McKeever, Patricia
O'Brien, Karel
Ohlsson, Arne
Fecha: 2006
2006-05-06
Publicador: McGill University
Fuente: Ver documento
Tipo: Text
Tema:
Descripción: BACKGROUND:A number of infant pain measures have been developed over the past 15 years incorporating behavioural and physiologic indicators; however, no reliable or valid measure exists for infants who are at risk for neurological impairments (NI). The objective of this study was to establish consensus about which behavioural, physiologic and contextual indicators best characterize pain in infants at high, moderate and low levels of risk for NI.METHODS:A 39- item, self-administered electronic survey that included infant physiologic, behavioral and contextual pain indicators was used in a two round Delphi consensus exercise. Fourteen pediatric pain experts were polled individually and anonymously on the importance and usefulness of the pain indicators for the 3 differing levels of risk for NI.RESULTS:The strength of agreement between expert raters was moderate in Round 1 and fair in Round 2. In general, pain indicators with the highest concordance for all three groups were brow bulge, facial grimace, eye squeeze, and inconsolability. Increased heart rate from baseline in the moderate and severe groups demonstrated high concordance. In the severe risk group, fluctuations in heart rate and reduced oxygen saturation were also highly rated.CONCLUSION:These data constitute the first step in contributing to the development and validation of a pain measure for infants at risk for NI. In future research, we will integrate these findings with the opinions of (a) health care providers about the importance and usefulness of infant pain indicators and (b) the pain responses of infants at mild, moderate and high risk for NI.
Idioma: eng