Pain assessment scales in newborns: integrative review

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.

Pain measurement; Newborn; Pain

One-dimensional tools
Acute pain	Prolonged pain	Acute and prolonged pain
ABC Pain Scale^a	Children’s and Infant’s Postoperative Pain Scale (CHIPPS)^b	Neonatal Facial Coding System (NFCS)^a
Neonatal Pain Analyzer - ABC analyzer^c	Distress Scale for Ventilated Newborn Infants (DSVNI)^a	Faces Legs Activity Cry Consolability Pain Scale (FLACC)^b
Douleur Aigue du Nouveau-Née (DAN)^a	Liverpool Infant Distress Score (LIDS)^d
Échelle Douleur Inconfort Nouveau-Né (EDIN)^a	Nursing Assessment of Pain Intensity (NAPI)^b
Behavioral Indicators of Infant Pain (BIIP)^d	Riley Infant Pain Scale (RIPS)^b
Behavioral Indicators of Infant Pain (BIIP)^d	Visual Analog Scale (VAS)^b

Multidimensional tools
Acute pain	Prolonged pain	Acute and prolonged pain
Pain Assessment in Neonates (PAIN)^a	Crying, requires oxygen, increased vital signs, expressions and sleepless (CRIES)^b	COMFORT^c Adapted COMFORT Scale^b COMFORT behavior Scale (COMFORT– B)^c
Infant Body Coding System (IBCS)^b
Bernese Pain - Scale for Neonates (BPSN)^b	Neonatal-Pain, Agitation and Sedation Scale (N-PASS)^b	Premature Infant Pain Profile (PIPP)^b
Scale for use in Newborns (SUN)^b	Multidimensional Assessment Pain Scale (MAPS)^c
Hartwig^c	Multidimensional Assessment Pain Scale (MAPS)^c
Neonatal Infant Pain Scale (NIPS)^b	Pain Assessment Tool (PAT)^b
Pain Assessment Scale for Preterm Infants (PASPI)^a
Nepean Neonatal Intensive Care Unit Pain Assessment Tool (NNICUPAT)^b

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[1] *Corresponding author.E-mail:aninhanurse@hotmail.com (A.L.P.A. Lélis).