Neonatal Infant Acute Pain Assessment Scale

Instrument Name: Neonatal Infant Acute Pain Assessment Scale

Abbreviation: NIAPAS

Points for Consideration:

None

Description of Tool:

The Neonatal Infant Acute Pain Assessment Scale (NIAPAS) is an 8-item ObsRO developed for infants in the neonatal intensive care unit. The NIAPAS includes five behavioral and three physiological indicators rated for each neonate on a 2 (0,1), 3 (0,1,2) or 4 (0,1,2,3)-level scale. Higher scores represent higher pain.

Other Related Tools (if applicable):

None identified

Minimum Qualification Required by COA Administrator: PhD or MA

Comment:

None

Year: 2014

Objective of Development:

To develop a multidimensional scale sensitive to the needs of infants in neonatal intensive care units.

Population of Development: Age range (therapeutic indication):

Age range: 23-42 weeks gestational age (Pain)

Pediatric Population(s) in which COA has been used:

Neonates undergoing painful procedures

COA type: ObsRO

Number of Items 8

Mode of Administration: Clinician-rated

Data Collection Mode: No information

Time for Completion: On average 61.4s (range: 5-300s, SD 70.7)

Response Scales: 2, 3, or 4-point scale (0, 1; or 0, 1, 2; or 0, 1, 2, 3)

Summary of Scoring:

Available scores: Possible total score of 18.

Weighting: No

Score Interpretation: Higher score = Higher pain

Evidence of Literature Review: None identified

Evidence of Instrument Review: None identified

Evidence of Clinical or Expert Input: Yes

Evidence of concept elicitation in target patient population: None identified

Evidence of a Saturation Grid: None identified

Evidence for Selection of Data Collection Method: None identified

Recall/Observation Period: Present time

Evidence for Selection of Reponse Options: None identified

Evidence of cognitive interviewing of draft instrument in target patient population: None identified

Evidence of Preliminary Scoring of Items and Domains: None identified

Evidence related to respondent and administrator burden: None identified

Evidence of a Conceptual Framework: None identified

Evidence of an item-tracking matrix: None identified

Evidence related to item selection: None identified

Evidence of re-testing the final version: Yes

Internal consistency (Cronbach's alpha): Yes

Evidence of internal consistency: Pölkki T (2014) - Method: Cronbach's alpha - Results: 0.73 - Population/Disease: Neonates (born between 23 and 42 weeks gestational age) who were undergoing 60 painful procedures; n=34

Test-retest Reliability (ICC):

None identified

Inter-rater/ inter-interviewer reliability (kappa):

Pölkki T (2014)
Interrater reliability
- Correlation Coefficient used: Not stated. Reliability ranged from 0.991 to 0.997; p Not stated for all results
- Population/Disease: n=34 neonates (born between 23 and 42 weeks gestational age) who were undergoing 60 painful procedures.

Pölkki T (2014)
Intrarater reliability
- Correlation Coefficient used: Not stated. Reliability ranged from 0.997 to 1.00
- Population/Disease: n=34 neonates (born between 23 and 42 weeks gestational age) who were undergoing 60 painful procedures.

Evidence of test-retest or inter-rater reliability: Yes

Concurrent validity (convergent, divergent):

Pölkki T (2014)
Convergent validity
- Correlation coefficient used: Pearson's r
- Measures: NIAPAS; Neonatal Infant Pain Score (NIPS)
- Timepoints: 1 minute before; during; 1 min after painful procedure (heel lance or tracheal suctioning)
- Results:
Before: r=0.751, p<0.001 During: r=0.873, p<0.001 After: r=0.804, p<0.001 - Population/Disease: Neonates (born between 23 and 42 weeks gestational age) who were undergoing 60 painful procedures; n=34

Known-group validity:

None identified

Evidence of Translatability Assessment: None identified

Evidence related to missing data: None identified

Evidence for Selection of Recall Period: None identified

Evidence of Administration Instructions and Training Provided: Yes

Evidence of concurrent validity: Yes

Evidence of known-groups validity: None identified

Evidence of ability to detect change over time: None identified

Ability to detect change (Responsiveness):

None identified

Responder Thresholds:

None identified

Evidence of responder thresholds: None identified

Pölkki, T., Korhonen, A., Axelin, A., Saarela, T., & Laukkala, H. (2014). Development and preliminary validation of the Neonatal Infant Acute Pain Assessment Scale (NIAPAS). International journal of nursing studies, 51(12), 1585–1594. Full Text Article: https://pubmed.ncbi.nlm.nih.gov/24815773/

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Yes

Original language: English

Translation (PROQOLID): 1 translation (not specified)

None identified

Author:
Tarja Polkki
Institute of Health Sciences, P.O. Box 5000, 90014 University of Oulu, Finland

Contact: tarja.polkki@nic.fi, tarja.polkki@oulu.fi

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