Development of a Premature Infant Pain Scale (PIPS)

Kim, Mi Soon; Kim, Mi Jin; Ham, Eun Ha; Kim, Kyoungmi

Abstract

PURPOSE: To develop and validate a scale suitable and efficient scale for use in clinical practice as to assess pain in premature infants. METHOD: Pain indicators identified by observation of preterm infants. A cohort of preterm infants was studied prospectively to determine the construct validity, inter-rater reliability, and internal consistency of the scale. The PIPS uses four indicators of pain: corrected gestational age, heart rate, oxygen saturation, behavioral state. The validation study included 45 premature infants with gestational age of 37 weeks or less.
RESULTS
The inter-rater reliability of the PIPS was acceptable, with Pearson correlations ranging from .720 to .970. Internal consistency was high: Cronbach's alpha coefficients ranged from .551 to .653. There was a strong correlation between the PIPS and PIPP scores (each researcher's r=.743, each indicator's r=.914). Although gestational age showed no association between these factors and the sum, the other variables were positively associated with the sum. Time needed to calculate PIPS scores is was less than Premature Infant Pain Profile (PIPP) scores(p<.000).
CONCLUSION
The validation data suggest that the PIPS is appropriate and efficient for assessing pain in premature infants. Further studies are required about to determine appropriate interventions for each pain score on the PIPS.