关键词: 新生儿, 疼痛, 手术后, 护理评估, 量表, 信度, 效度

Abstract:

Objective To test the reliability and validity of the COMFORTneo Scale for postoperative pain assessment in Chinese neonates. Methods Through translation，back translation，expert review and pretest，the Chinese version of the COMFORTneo Scale was formed. 52 neonates at the Neonatal Intensive Care Unit in a tertiary general hospital of Guangzhou were recruited from September 2021 to June 2022. Neonates were observed 7 times（preoperatively and 48 hours postoperatively），and recorded for 2 minutes at each encounter including facial expressions and body movements. 2 researchers scored the Chinese COMFORTneo Scale and the Numeric Rating Scale independently while viewing the video clips. 2 weeks later，one of the researchers randomly selected 10 of the neonates’ video clips，viewed and scored them again. The reliability and validity of the scale were evaluated. Results 48 neonates were included，with 4 dropouts. The Chinese COMFORTneo Scale was composed of alertness，calmness/agitation，respiratory response（only in mechanically ventilated neonates），crying（only in spontaneously breathing neonates），body movement，facial tension，and muscle tone（observation only）. In mechanically ventilated and spontaneously breathing neonates，exploratory factor analysis extracted one factor of each，and the factor cumulative variance contribution rates were 57.042% and 66.378%，respectively. The Cronbach’s α coefficients of the scale were 0.819 and 0.885；test-retest reliability was 0.977 and 0.968，respectively. The scores of the Chinese COMFORTneo Scale were significantly positively correlated with the Numeric Rating Scale（r=0.920）. The cut-off value of the Chinese COMFORTneo Scale was 15 and 20 for moderate and severe pain，respectively. Conclusion The Chinese COMFORTneo Scale had good validity and reliability when used to assess postoperative pain in neonates.

Key words: Neonates, Pain, Postoperative, Nursing Assessment, Scale, Reliability, Validity