title: Meanings of discomfort and fussy-irritable in infant pain assessment.
abstract: The purpose of this study was to describe the clinical meaning and customary use of the terms discomfort and fussy-irritable by pediatric nurses. This descriptive study used a purposive sample of 60 pediatric nurse participants who had a Bachelor of Science in Nursing degree and different lengths of pediatric nursing experience. Participants were interviewed as they assessed pain levels of videotaped infants. Interviews were analyzed with both qualitative and quantitative descriptive methods. Qualitative findings suggest that for participants, "discomfort" meant noxious sensations for which narcotic analgesics would not be appropriate management, and "pain" implied noxious sensations for which narcotic analgesics were warranted. "Fussy-irritable" meant mild infant arousal that did not demand urgent attention. Quantitative findings showed that: (a) assessments of fussy-irritable were consistent with qualitative findings, but assessments of discomfort were not, and (b) pediatric nurses are socialized concerning the clinical meanings of these terms between their first and fifth year of pediatric practice. This study identifies clinical meanings implicit in the assessment terms of "discomfort," "pain," and "fussy-irritable" and shows that individual participants did not always use terms in the same way. Inconsistent meanings and use of such terms can confound communication among nurses and hamper the learning of infant pain assessment by novices.
authors.affiliation: School of Nursing at the University of Colorado Health Sciences Center, Denver 80262, USA.
authors.forename: B
authors.initials: B
authors.lastname: Fuller
mesh_terms: D002983:Clinical Competence; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007508:Irritable Mood; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D010146:Pain / Q000175:diagnosis*; D010371:Pediatric Nursing / Q000193:education; D012660:Semantics