The sensitivity of the premature infant pain profile - PIPP to measure pain in hospitalized neonates.

Aim: The present study uses an Icelandic translation of the original version of the Premature Infant Pain Profile (PIPP) in order to assess its accuracy and sensitivity to the measure of pain in hospitalized neonates in Iceland. The PIPP is a composite tool developed to assess acute pain in preterm and term neonates.

Methods: A crossover design, with a sample of 24 neonates, was used on three, routinely occurring events in the neonatal intensive care unit, where neonates were their own controls. The three events were baseline, non-pain and pain event. Neonates were independently assessed for their pain, using the Icelandic translation of the PIPP, at the bedside.

Results: Repeated measures analysis yielded a statistically significant main effect for the three events (pain, non-pain and baseline), thus differentiating pain from non-pain and baseline events (F = 57.11; P < 0.0001). Pair-wise comparisons were subsequently carried out and the results show that PIPP scores at the pain event (11.72) were significantly lower (P < 0.0001) than that at the non-pain event (6.04) and that at the baseline event (3.54; P < 0.0001). The PIPP scores at the non-pain event were also significantly higher than that at the baseline event (P < 0.0001). These results suggest that the PIPP measure is sensitive to a painful event and differentiates between stress and pain in a clinical context across linguistic barriers. The findings also revealed almost a complete correlation between the PIPP scores of the two independent nurse raters at all events (P < 0.0001).

Conclusion: Therefore the authors conclude that the Icelandic translation of the PIPP qualifies as a satisfying measure of pain responses in Icelandic neonates and can be recommended for use by clinicians and researchers. More research is, however, needed to further the accuracy and validity of the PIPP measure in general to assess pain in neonates in comparison to other pain measures.