Prolonged Pain in Premature Neonates Hospitalised in the NICU: A Principle Based Concept Analysis
Bibliographic record
Abstract
BACKGROUND: Premature neonates in neonatal intensive care units face frequent exposure to noxious stimuli, leading to acute, prolonged, or chronic pain. Despite its impact, prolonged pain remains poorly defined and managed due to inconsistent terminology in the literature and lack of understanding in the scientific and clinical communities. OBJECTIVE: This concept analysis seeks to establish a clear theoretical definition of prolonged pain in premature neonates hospitalised in neonatal intensive care units. METHODS: This concept analysis follows the principle-based (epistemology, pragmatic, linguistic and logic) concept analysis methodology described by Smith and Mörelius (2021) using a phased approach with quality evaluation. A systematic search was conducted in ten multidisciplinary health related databases, the grey literature, as well as manual searches of references. Articles were systematically screened two independent reviewers. A hybrid approach was used for the analysis, more specifically, deductive analysis was used for the epistemological principle using Anand's (2017) theoretical pain framework and inductive analysis was used for the pragmatic, linguistic and logic principles. RESULTS: This analysis encompassed 81 articles published between 1997 and 2026, revealing theoretical convergence elements pertaining to the principles of epistemology, pragmatism, linguistics and logic. A comprehensive definition emerged from the conceptual components (preconditions, characteristics and outcomes) informed by the four principles. IMPLICATION FOR PRACTICE: This definition will improve the identification, evaluation, and treatment of prolonged pain in hospitalised premature infants, while standardising pain taxonomy in premature infants and enhancing both the scientific and clinical understanding of their pain experiences.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.074 | 0.109 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.025 | 0.019 |
| Science and technology studies | 0.002 | 0.005 |
| Scholarly communication | 0.007 | 0.005 |
| Open science | 0.003 | 0.005 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".