Healthcare professionals' perceptions of pain in infants at risk for neurological impairment.
BACKGROUND
To determine whether healthcare professionals perceive the pain of infants differently due to their understanding of that infant's level of risk for neurological impairment.


METHODS
Neonatal Intensive Care Units (NICU's) at two tertiary pediatric centers. Ninety-five healthcare professionals who practice in the NICU (50 nurses, 19 physicians, 17 respiratory therapists, 9 other) participated. They rated the pain (0-10 scale and 0-6 Faces Pain Scale), distress (0-10), effectiveness of cuddling to relieve pain (0-10) and time to calm without intervention (seconds) for nine video clips of neonates receiving a heel stick. Prior to each rating, they were provided with descriptions that suggested the infant had mild, moderate or severe risk for neurological impairment. Ratings were examined as a function of the level of risk described.


RESULTS
Professionals' ratings of pain, distress, and time to calm did not vary significantly with level of risk, but ratings of the effectiveness of cuddling were significantly lower as risk increased [F (2,93) = 4.4, p = .02]. No differences in ratings were found due to participants' age, gender or site of study. Physicians' ratings were significantly lower than nurses' across ratings.


CONCLUSIONS
Professionals provided with visual information regarding an infants' pain during a procedure did not display the belief that infants' level of risk for neurological impairment affected their pain experience. Professionals' estimates of the effectiveness of a nonpharmacological intervention did differ due to level of risk.
Breau
Lynn M
LM
Pediatric Pain Service, IWK Health Centre, 5850 University Ave,, P,O, Box 9700, Halifax, Nova Scotia, B3K 6R8, Canada. lbreau@ns.sympatico.ca
McGrath
Patrick J
PJ
Stevens
Bonnie
B
Beyene
Joseph
J
Camfield
Carol S
CS
Finley
G Allen
GA
Franck
Linda
L
Howlett
Alexandra
A
O'Brien
Karel
K
Ohlsson
Arne
A
D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002170:Canada; D004645:Empathy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007224:Infant Care / Q000379:methods*; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007600:Judgment; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications*; D010146:Pain / Q000209:etiology* / Q000534:rehabilitation*; D010147:Pain Measurement; D010564:Personnel, Hospital; D018570:Risk Assessment; D000078329:Workforce