title: A reliable pain assessment tool for clinical assessment in the neonatal intensive care unit.
abstract: OBJECTIVE
  The aim of this study was to validate a clinician-friendly pain assessment tool for all groups of critically ill infants cared for in the specific neonatal intensive care units (NICUs) studied.
  
  
  METHODS
  A prospective study was undertaken to test the Pain Assessment Tool (PAT). Interrater reliability of the PAT score was assessed by two nurses who simultaneously determined an infant's PAT score. The PAT was validated against the CRIES score--crying, requires increased oxygen administration, increased vital signs, expression, sleeplessness--and the mother's assessment of her infant's discomfort using the Visual Analogue Scale (VAS).
  
  
  METHODS
  The NICUs at two children's hospitals.
  
  
  METHODS
  Participants were 144 preterm and term infants. Infants on a ventilator and those who had undergone surgery were included.
  
  
  RESULTS
  The interrater reliability of the PAT was .85 with a mean difference of 0.17 (standard deviation: 1.73). There was a strong correlation between the PAT and CRIES scores (r = 0.76) and a moderate correlation (.38) between the PAT score and the VAS scores of the infant's mother. The correlation coefficient between the PAT score and CRIES score was significant for all groups (p < .01).
  
  
  CONCLUSIONS
  The PAT score was shown in this study to be a valid, reliable, and clinician-friendly pain assessment measurement tool for all infants nursed in the NICU.
authors.affiliation: Department of Neonatology, Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia. kaye@chw.edu.au
authors.forename: Kaye
authors.initials: K
authors.lastname: Spence
authors.forename: Donna
authors.initials: D
authors.lastname: Gillies
authors.forename: Denise
authors.initials: D
authors.lastname: Harrison
authors.forename: Linda
authors.initials: L
authors.lastname: Johnston
authors.forename: Sue
authors.initials: S
authors.lastname: Nagy
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000451:nursing / Q000628:therapy*; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D017283:Neonatal Nursing / Q000379:methods; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000451:nursing; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods* / Q000451:nursing; D017288:Pain Threshold; D010149:Postoperative Pain / Q000175:diagnosis / Q000451:nursing; D011446:Prospective Studies; D015203:Reproducibility of Results; D012121:Respiration, Artificial; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index