Judgments of pain in the neonatal intensive care setting: a survey of direct care staffs' perceptions of pain in infants at risk for neurological impairment.
OBJECTIVE
To determine whether healthcare professionals believe the pain of infants at risk for neurologic impairment differs from that of typical infants.


METHODS
Neonatal intensive care units at 2 tertiary pediatric centers in Canada.


METHODS
Ninety-nine healthcare professionals who practice in the neonatal intensive care unit (51 nurses, 19 physicians, 18 respiratory therapists, 11 other). MAJOR MEASURES: Participants completed the Pain Opinion Questionnaire. It elicits beliefs regarding the similarity of the pain experienced by infants at mild, moderate, and severe risk for neurologic impairment relative to those without risk for neurologic impairment along 5 pain facets (ie, sensation, emotional reaction, behavioral reaction, communication, incidence).


RESULTS
Pain Opinion Questionnaire scores varied by level of risk of neurologic impairment (mild, moderate, severe) and pain facet. Respondents believed infants with risk were overall less likely to experience pain similar to infants without risk as the level of risk increased [F(2,97) = 66.0, P < 0.001] and were more likely to have a reduced pain experience relative to infants without risk as the level of risk increased [F(2,97) = 62.2, P < 0.001]. Pain Opinion Questionnaire scores did not vary due to profession, experience, gender, or age.


CONCLUSIONS
Professionals expressed the belief that neurologically impaired infants' pain experience is reduced, relative to infants without impairment, as their level of risk for neurologic impairment increases. This belief did not vary due to professional experience or personal factors. Future studies should investigate the source of these beliefs and their impact on the pain management provided to infants with risk for neurologic impairment.
Breau
Lynn M
LM
Pediatric Pain Service, IWK Health Centre, Halifax, Nova Scotia, Canada. lbreau@ns.sympatico.ca
McGrath
Patrick J
PJ
Stevens
Bonnie
B
Beyene
Joseph
J
Camfield
Carol
C
Finley
G Allen
GA
Franck
Linda
L
Gibbins
Sharyn
S
Howlett
Alexandra
A
McKeever
Patricia
P
O'Brien
Karel
K
Ohlsson
Arne
A
D000328:Adult; D000488:Allied Health Personnel; D001291:Attitude of Health Personnel; D001519:Behavior; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D003142:Communication; D003469:Culture; D003625:Data Collection; D004501:Education, Medical; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology*; D009726:Nurses; D010146:Pain / Q000150:complications*; D010147:Pain Measurement; D010290:Parents / Q000523:psychology; D010820:Physicians; D011379:Prognosis; D018570:Risk Assessment; D011795:Surveys and Questionnaires