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Arch Dis Child Fetal Neonatal Ed 2001;85:F36-F41 ( July )

Development and initial validation of the EDIN scale, a new tool for assessing prolonged pain in preterm infants

T Debillona, V Zupanb, N Ravaulta, J-F Magnyc, M Dehanb

a Neonatal Intensive Care Unit, Mother-Child University Hospital, Nantes, France, b Neonatal Intensive Care Unit, Antoine Béclère University Hospital, Clamart, France, c Neonatal Intensive Care Unit, Infant Care Institute, Paris, France

Correspondence to: Dr Debillon, Service de Réanimation Néonatale, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Nantes, 44 093 Nantes Cedex 01, France thierry.debillon{at}chu-nantes.fr

Accepted 26 January 2001

OBJECTIVE---To develop and validate a scale suitable for use in clinical practice as a tool for assessing prolonged pain in premature infants.
METHODS---Pain indicators identified by observation of preterm infants and selected by a panel of experts were used to develop the EDIN scale (Échelle Douleur Inconfort Nouveau-Né, neonatal pain and discomfort scale). A cohort of preterm infants was studied prospectively to determine construct validity, inter-rater reliability, and internal consistency of the scale.
RESULTS---The EDIN scale uses five behavioural indicators of prolonged pain: facial activity, body movements, quality of sleep, quality of contact with nurses, and consolability. The validation study included 76 preterm infants with a mean gestational age of 31.5 weeks. Inter-rater reliability was acceptable, with a kappa  coefficient range of 0.59-0.74. Internal consistency was high: Cronbach's alpha  coefficients calculated after deleting each item ranged from 0.86 to 0.94. To establish construct validity, EDIN scores in two extreme situations (pain and no pain) were compared, and a significant difference was observed.
CONCLUSIONS---The validation data suggest that the EDIN is appropriate for assessing prolonged pain in preterm infants. Further studies are warranted to obtain further evidence of construct validity by comparing scores in less extreme situations.


Keywords: prolonged pain; pain scale; assessment; validation; premature


© 2001 by Archives of Disease in Childhood



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