不同量表用于机械通气新生儿急性疼痛评估的价值分析

Analysis of the Values of Different Scales for Acute Pain Assessment in Mechanically Ventilated Neonates

目的:分析和比较不同量表用于机械通气新生儿急性疼痛评估的价值。方法:使用总结性、回顾性研究方法,研究时间为2017年3月份到2018年7月份,选择在医院NICU接受机械通气诊治的新生儿56例作为研究对象,所有新生儿都给予高频震荡通气治疗,急性疼痛采用新生儿疼痛/激惹与镇静量表、新生儿急性疼痛评估量表进行评估与分析,记录评估效果。结果:新生儿疼痛/激惹与镇静量表的总体Cronbachα系数为0.698分,最高评分为基础行为状态,最低评分为心率增快。新生儿急性疼痛评估量表的内部一致性总体Cronbachα系数为0.822,最高评分为胎龄,最低评分为SaO2。新生儿疼痛/激惹与镇静量表的护理人员一致性组内相关系数(ICC)为0.992,新生儿急性疼痛评估量表的护理人员一致性组内相关系数ICC为0.987。以新生儿疼痛/激惹与镇静量表作为效标,新生儿急性疼痛评估量表的效标关联效度Spearman相关系数为r=0.855,P=0.007。12名护理人员对新生儿急性疼痛评估量表的选择率为66.7%,对新生儿疼痛/激惹与镇静量表的选择率为33.3%。结论:新生儿疼痛/激惹与镇静量表和新生儿急性疼痛评估量表在机械通气新生儿急性疼痛评估中都有很好的信度与一致性,其中新生儿急性疼痛评估量表的可行性和临床实用性更好。

Objective: To analyze and compare the value of different scales for the assessment of acute pain in mechanically ventilated neonates. Methods: A summary and retrospective study method were used. The study time were from March 2017 to July 2018. 56 neonates who received mechanical ventilation in hospital were selected as the research subjects. All newborns were given high frequency oscillating ventilation, the acute pain were assessed and analyzed by using the Neonatal Pain/Irritation and Sedation Scale, Neonatal Acute Pain Assessment Scale, and the assessment were recorded. Results: The overall Cronbach alpha coefficient of the Neonatal Pain/Irritation and Sedation Scale were 0.698, with the highest score being the underlying behavioral state and the lowest score being the increased heart rate. The internal consistency of the Neonatal Acute Pain Assessment Scale of Cronbach alpha coefficient were 0.822, with the highest score being gestational age and the lowest score being SaO2. The correlation coefficient(ICC) for the caregiver of the neonatal pain/irritation and sedation scale were 0.992, and the correlation coefficient ICC for the caregiver consistency group on the neonatal acute pain assessment scale were 0.987. Using the Neonatal Pain/Irritation and Sedation Scale as a criterion, the Spearman correlation coefficient of the Newborn Acute Pain Assessment Scale were r=0.855, P=0.007. 12 Nursing Staff Assessment of Acute Pain in Newborns The selection rate of the scale were 66.7%, and the selection rate for the neonatal pain/irritation and sedation scale were 33.3%. Conclusion:The Neonatal Pain/Irritation and Sedation Scale Neonatal Acute Pain Assessment Scale has good reliability and consistency in the assessment of acute pain in mechanically ventilated neonates. The feasibility of the Neonatal Acute Pain Assessment Scale And clinical utility is better.