title: The premature infant pain profile-revised (PIPP-R): initial validation and feasibility.
abstract: OBJECTIVE
  To describe revisions to the Premature Infant Pain Profile (PIPP) and initial construct validation and feasibility of the Premature Infant Pain Profile-Revised (PIPP-R).
  
  
  METHODS
  The PIPP was revised to enhance validity and feasibility. To validate the PIPP-R, data from 2 randomized cross-over studies were utilized to: (1) calculate and compare PIPP and PIPP-R scores in extremely low gestational age infants undergoing a painful and nonpainful event (N=52; dataset #1) and (2) calculate and compare PIPP and PIPP-R scores in assessing the effectiveness of (a) sucrose, (b) non-nutritive sucking (NNS)+sucrose, and (c) facilitated tucking+NNS+sucrose during heel lance (N = 85; dataset #2). Pearson correlations between PIPP and PIPP-R scores were calculated, and Student t tests and 1-way analysis of variance were used to determine construct validity during painful and nonpainful events. To establish feasibility, a survey of 31 Neonatal Intensive Care Unit nurses was conducted.
  
  
  RESULTS
  PIPP-R scores were significantly lower during nonpainful (mean, 8.3; SD = 2.9) compared with painful (mean, 9.9; SD=3.1; t95 = 4.51, P = 0.036) events in extremely low gestational age infants in dataset #1. In dataset #2, PIPP-R scores were significantly lower in infants 25 to 41 weeks gestation in the group receiving NNS+sucrose compared with the other 2 groups (F2,79 = 2.9, P<0.05). Overall, nurses rated the PIPP-R as feasible.
  
  
  CONCLUSIONS
  Initial construct validation and feasibility of the PIPP-R was demonstrated. Further testing with infants of varying gestational ages, diagnoses, and pain conditions is required; as is exploration of PIPP-R in relation to other types of physiological and cognitive responses.
authors: *The Hospital for Sick Children †Lawrence S. Bloomberg Faculty of Nursing ¶Leslie Dan Faculty of Pharmacy, The University of Toronto, Toronto, ON ‡The Credit Valley Hospital Trillium Health Centre, Mississauga, ON §Ingram School of Nursing, McGill University, Montréal, QC ∥IWK Health Centre, Halifax, NS, Canada.
authors: Bonnie J
authors: BJ
authors: Stevens
authors: Sharyn
authors: S
authors: Gibbins
authors: Janet
authors: J
authors: Yamada
authors: Kimberley
authors: K
authors: Dionne
authors: Grace
authors: G
authors: Lee
authors: Céleste
authors: C
authors: Johnston
authors: Anna
authors: A
authors: Taddio
mesh_terms: D005149:Facial Expression; D005240:Feasibility Studies; D005865:Gestational Age; D006339:Heart Rate; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D062071:Infant, Extremely Premature; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D009726:Nurses; D010146:Pain / Q000175:diagnosis*; D010147:Pain Measurement / Q000379:methods*; D010808:Physical Examination; D016032:Randomized Controlled Trials as Topic; D013391:Sucking Behavior; D013395:Sucrose
chemical_list: D013395:Sucrose