Psychometric analysis of a Taiwan‐version pain assessment scale for preterm infants
Bibliographic record
Abstract
AIM: To determine the inter-rater reliability, internal consistency, construct and concurrent validity and feasibility of the pain assessment scale for preterm infants. BACKGROUND: Repeated exposure to painful procedures has an adverse impact on preterm infants' health outcomes. Although many scales are available for assessing these infants' pain, only a few reliably and validly assess pain and no gold standard has been established in clinical practice. DESIGN: Instrument development and psychometric analysis. METHODS: Preterm infants (n = 60) born 27·6-36·3 weeks gestational age were assessed for pain 3 minutes before (phase I), during (phase II), 3 minutes after (phase III) and the tenth minute after (phase IV) heel-stick procedures. Pain scores were independently coded from video recordings and observations by three trained nurses using our pain-assessment scale, premature infant pain profile and visual analogue scale. RESULTS: Scores on the pain assessment scale for preterm infants differed significantly across four phases of heel-stick procedures (F = 56·86, p < 0·0001). Internal consistency was 0·84 and inter-rater reliability was 0·88-0·93. Scores on our pain scale correlated well with scores on the premature infant pain profile (0·74-0·83) and visual analogue scale (0·72-0·81). CONCLUSIONS: The pain assessment scale for preterm infants integrates all possible pain indicators, with each item modified for clinicians' simple and easy pain measurement to potentially yield different information. Our scale is valid, reliable and feasible for preterm infants with gestational age > 27 weeks. Further examination of the scale's psychometrics is recommended with diverse samples of infants and different painful procedures. RELEVANCE TO CLINICAL PRACTICE: The pain assessment scale for preterm infants clearly defines item scoring and weighting, consistently discriminates different levels of pain and helps nurses to recognise infants' pain. Nurses can easily remember the definition of each item, allowing them to use our scale to evaluate preterm infants' pain at any time and to provide pain-relief interventions when needed.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".