Neonatal pain assessment in Sweden - a fifteen-year follow up.
BACKGROUND
It has been proposed that a systematic pain assessment increases the awareness of the need to treat and prevent pain, and most international and national neonatal pain guidelines state that pain assessment should be performed in a systematic way. National surveys show a wide variation in compliance to these guidelines.


METHODS
A survey to all Swedish neonatal units was performed in 1993, 1998, 2003 and 2008, concerning the use of, and need for, pain assessment tools.


RESULTS
The number of units that tried to assess pain increased from 64% in 1993 to 83% in 2008. Forty-four per cent of these used a structured method in 2003, compared to three per cent in 1998. The most common pain indicator was facial actions.


CONCLUSIONS
The proportion of neonatal units that reported the use of a structured pain assessment tool has increased significantly from 1993 to 2008. There is a need for better evidence for the relation between the implementation of pain guidelines and the actual performance of pain assessment.
Gradin
Maria
M
Department of Paediatrics, Örebro University Hospital, Sweden. maria.gradin@orebroll.se
Eriksson
Mats
M
D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D010147:Pain Measurement / Q000379:methods / Q000706:statistics & numerical data*; D013548:Sweden; D013997:Time Factors