Neonatal pain assessment: the development of a pain assessment scale for neonatal transport

Abstract

The aim of this study is to develop a pain assessment scale for use during neonatal transport. Underpinned by the rights of the child to have appropriate assessment and management of pain and the important deleterious effects pain can have on the physiological stability of the neonate, this study utilises a qualitative consensus paradigm of enquiry to inform the content and structure a pain assessment scale specific to the transport setting.
The study was conducted in three Phases, the first Phase consisted of a nominal group meeting with transport clinicians to ascertain their views on items to include in a pain assessment scale for transport. Phase Two utilised the Delphi technique to gain consensus from a large cohort of clinicians experienced in the field of neonatal transport on the content, structure and design of a transport pain assessment scale.
Results of the first two Phases of the study were then applied to the adaptation of an existing pain assessment scale. Face validity of the newly developed Neonatal Transport Pain Assessment Scale (NTPAS) was then tested in Phase Three by semi-structured interviews with transport clinicians. Results of initial face validity testing suggested positive results in relation to feasibility and clinical utility of the scale, however further testing is strongly recommended.
Currently there are no pain assessment scales developed for use in the transport setting, and little evidence on the effects of transport on pain and pain assessment. This study offers a unique approach in adding to the body of knowledge on neonatal pain assessment and facilitated the development of a scale adapted to transport. Further research is suggested to undertake psychometric testing of the scale and establish validity and reliability in the clinical setting.

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