INFANT POST-OPERATIVE PAIN BEHAVIORS AND NURSES' DECISION-MAKING.
Contributors: University of North Carolina at Chapel Hill.
Published: 1993
Number of pages: 179
Subjects: Health Sciences, Nursing.; Psychology, Behavioral.; Health Sciences, Human Development.
Description: Accurate assessment and management of infant pain is crucial to the delivery of humane nursing care. Infants are believed to communicate their experience by physiologic and behavioral cues. Physiologic cues are not specific for pain and the Agency for Health Care Policy and Research (1992) recommends the use of behavioral observation as the primary pain assessment method for the nonverbal child. Little is known about the infant's behavioral response to post-operative pain. The purpose of this study was to explore how pediatric nurses' use infant behaviors in their decision-making about post-operative pain.

Eight young infants were videotaped within 24 hours of surgery. Duration of analgesics received was used to classify portions of the videotapes into 'in pain' and 'not in pain' segments. Fifty nurses observed 96 30-second videotape snippets and were asked to indicate whether or not they would medicate the infant for pain on the basis of the observed behaviors. A 'yes' response was interpreted as 'in pain' and a 'no' response was interpreted as a 'not in pain' diagnosis. The nurses answered questions about the observed infants' behaviors for a subset of these snippets. Educational and experiential data were collected from each nurse. Two observation experts viewed the videotapes and described the infant behaviors using a coding scheme developed for this study.

Using Signal Detection Theory, nurses' proportion agreement with the pharmacologic standard was approximately 50% and their sensitivity in differentiating the two pharmacologically defined pain conditions was essentially zero. The two pharmacologic pain classifications were not differentiated by infant behaviors reported by the observation experts. No nursing demographic characteristics were associated with diagnostic accuracy. Nurses diagnosing the presence of pain reported using the same behaviors described in the research literature, but not in any consistent group of behaviors.
Notes: Source: Dissertation Abstracts International, Volume: 54-12, Section: B, page: 6133.

Thesis (PH.D.)--THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL, 1993.

School code: 0153.