A Systematic Integrative Review of Infant Pain Assessment Tools

Lenora J. Duhn, RN, MSc; Jennifer M. Medves, RN, PhD


Adv Neonatal Care. 2004;4(3) 

In This Article

Design and Methods

A systematic literature review was conducted that focused on tools developed for neonatal pain assessment using the following databases: MEDLINE, CINAHL, Health and Psychosocial Instruments (HAPI), and the Cochrane Database of Systematic Reviews. The search in MEDLINE explored literature from 1966 to week 4 of February 2004. The medical subject heading (MeSH) term used was "pain measurement," with a limit of "newborn infant (birth to 1 month)." The scope of this MeSH is defined as "scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies." The search revealed 437 citations. Another limit used was "infant, premature" which revealed 72 citations.

The CINAHL database was also explored. The review tracked publications between 1982 and week 4 of February 2004. The subject heading "pain measurement" with a limit of "newborn infant (birth to 1 month)" was used. Using this search strategy, 233 citations were then reviewed to elicit any new pain assessment tools.

The HAPI database was also searched. This database was investigated using the descriptors "infant newborn" and "pain perception" during the time period of 1985 to December 2003. Seven citations resulted. These were reviewed with another search that used the descriptors "pain and infants"; there was, however, overlap with a number of the citations.

The final database examined was the Cochrane Database of Systematic Reviews. The review spanned a time frame from 1988 to 2003. The Cochrane subject headings included "pain measurement" and "infant, newborn," which yielded 107 citations. Although there were no systematic reviews specific to neonatal pain measurement, the references from the systematic review on sucrose for analgesia in newborn infants undergoing painful procedures directed the search to several pain assessment tools.

A historical search, using the reference lists and bibliographies of published articles that were obtained using the 4 databases, was also completed. Additionally, authors were contacted for clarification as required, in particular for information about clinical utility. There was no effort made to specifically seek out unpublished works, such as research abstracts or dissertations.


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