DEVELOPMENT OF BEHAVIORAL INDICATORS FOR PAIN ASSESSMENT OF PRETERM INFANTS

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The purpose of this study was to develop behavioral indicators for pain assessment of preterm infants. Subjects were 26 preterm infants who met the inclusion criteria of being less than 32 weeks gestational age at birth and having no neurologic abnormalities, and whose parents gave consent. Physiologic and behavioral data was collected at 97 sessions for routine procedures (heel stick, venipuncture, insertion or removal of feeding tube). Facial actions were videotaped, analyzed qualitatively and quantitatively, and we explored the relation to body movement, HR and RR.Results were as follows: 1) HR and RR were not specific pain response because no significant difference was found between disinfection phase and stick/puncture phase; 2) Twist of shoulder or trunk and bend of arm or leg were found on painful stimuli such as stick/puncture and squeeze on blood sampling; 3) 12 facial expressions were qualitatively found and classified into 4 types quantitatively. The rate of change of facial action showed a significant difference among each type.Through the above results, a pain scale of preterm infants which is composed of facial expression and body movement, classified into 4 levels as pain response was made. This pain scale should be examined for reliability and validity for nurses to use for care of oreterm infants havine oain.