Abstract
The effectiveness of pain-reducing interventions in newborns can only be determined
if pain measurement instruments are responsive; that is, able to detect a decrease
in pain intensity after the pain-reducing intervention. This review assesses the methodologic
quality of studies on this measurement property—the responsiveness. We searched the
literature published until January 2018 for validation studies of pain measurement
instruments focusing on responsiveness to pain-reducing treatment in neonates. The
methodologic quality of the included studies was rated using the COnsensus-based Standards
for the selection of health Measurement INstruments checklist. Nine studies were included
involving 10 pain measurement instruments. These studies differed with respect to
the population, setting and type of pain-reducing intervention. In all studies, pain
scores were significantly lower after a pain-reducing intervention and the instrument
used was therefore considered responsive. We rated 4 studies as having poor methodologic
quality, 5 as fair quality, and none as good quality. In conclusion, the responsiveness
was studied for only 10 of the 43 existing pain measurement instruments for the use
in neonates. Because this is an important property of a pain instrument, more research
on this topic is needed, with attention for blinding and formulating a specific hypothesis
before start of data collection.
Perspective
This review focuses on the property of measurement instruments to detect changes in
pain intensity after a pain-reducing intervention in neonates. We concluded that this
property—the responsiveness—is under studied and that the methodologic quality of
the included studies was low. Future high-quality validation studies should focus
on responsiveness.
Key words
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Article info
Publication history
Published online: December 23, 2018
Footnotes
The authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
Copyright
© 2018 by the American Pain Society
