It is currently thought that infant pain remains undertreated due to a lack in knowledge concerning valid indicators of pain in infants that are requisite for the accurate assessment of infant pain. The general purpose of this research is to explicate age-appropriate models of infant pain which can be used as a basis for the development of a clinical tool(s) to improve nursing assessment of infant pain. Enhanced assessment will facilitate improved pain management for infants. A multimethod, multiple modality approach will be utilized to do this. Ethologically described visible infant behaviors, vocal measures, physiological and certain acoustic measures of stress-arousal, cues nurses report using infant pain assessment, and nurse-assessed levels of pain will be obtained for 80 study infants. These will be fully described and interrelationships among them explored.
Five specific aims guide the attainment of this overall purpose. 1) To describe the following variables within each of the assessed levels of pain for infants in four age categories: a) infant background variables, b) ethnographically derived assessment cues/patterns of cues reported by pediatric nurses, c) ethologically derived vocal and visible behavioral variables, d) vocal and physiological variables suggestive of stress- arousal. 2) To elucidate assessment cues by: (a) describing how cues and/or cue patterns in Aim 1b are selected, organized, weighted and otherwise used in making a nursing assessment about the level of pain experienced by infants; (b) identifying specific elements of any global cues through a combination of ethological and ethnographic analyses; and (c) describing the similarities and differences in cues, cue-patterns, global cue elements and their organization both across nurses and across infants with different levels of assessed pain and in the different age categories. 3) To identify patterns of similarities and differences of ethologically derived variables across infants of similar and different ages and assessed levels of pain. 4) To examine the interrelatedness of the following within and across age categories of infants: (a) infant background variables; (b) vocal and physiological variables associated with stress arousal; and (e) assessed 1c and 3; (d) vocal and physiological variables associated with stress arousal; and (e) assessed level-of-pain ratings. 5) Using the results of all qualitative and quantitative analyses, to construct a model(s) that can be used to develop a refined clinical tool to improve nursing assessment of infant pain.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR002044-02
Application #
3391973
Study Section
Nursing Research Study Section (NURS)
Project Start
1990-09-30
Project End
1995-08-31
Budget Start
1991-09-01
Budget End
1992-08-31
Support Year
2
Fiscal Year
1991
Total Cost
Indirect Cost
Name
University of Colorado Denver
Department
Type
Schools of Nursing
DUNS #
065391526
City
Aurora
State
CO
Country
United States
Zip Code
80045
Neu, Madalynn; Fuller, Barbara F (2003) Confounding factors in infant pain assessment during recovery from anesthesia. J Spec Pediatr Nurs 8:45-51
Fuller, Barbara F (2002) Infant gender differences regarding acute established pain. Clin Nurs Res 11:190-203
Fuller, B F; Neu, M (2001) Generalizability and clinical utility of a practice-based infant pain assessment instrument. Clin Nurs Res 10:122-39
Fuller, B F (2001) Infant behaviors as indicators of established acute pain. J Soc Pediatr Nurs 6:109-15
Fuller, B F; Neu, M (2000) Validity and reliability of a practice-based infant pain assessment instrument. Clin Nurs Res 9:124-43
Fuller, B F; Neu, M; Smith, M (1999) The influence of background clinical data on infant pain assessments. Clin Nurs Res 8:179-87
Fuller, B F; Neu, M; Smith, M et al. (1999) Testing a model of the nursing assessment of infant pain. Clin Nurs Res 8:69-83
Seymour, E; Fuller, B F; Pedersen-Gallegos, L et al. (1997) Modes of thought, feeling, and action in infant pain assessment by pediatric nurses. J Pediatr Nurs 12:32-50
Fuller, B F; Conner, D A (1997) The influence of length of pediatric nursing experience on key cues used to assess infant pain. J Pediatr Nurs 12:155-68
Fuller, B; Thomson, M; Conner, D A et al. (1996) Relationship of cues to assessed infant pain level. Clin Nurs Res 5:43-66

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