Reliability and validity of Japanese version of Neonatal Pain, Agitation, and Sedation Scale for acute pain in infants

BACKGROUND: To assess the clinical validity and reliability of the Neonatal Pain, Agitation, and Sedation Scale (N-PASS) for acute pain in infants with illnesses treated in the neonatal intensive care unit (NICU). METHODS: Data of 32 infants were collected. NICU nurses measured pain and distress scores using the Japanese version of the N-PASS (henceforth, N-PASS-J) at baseline and during skin puncture. To determine internal consistency, discriminant validity, and convergent validity, we calculated Cronbach's alpha, conducted a one-way repeated measures ANOVA, and examined correlation coefficients with established pain measurement tools. RESULTS: Data were collected for 122 scenes: 61 at baseline and 61 at the time of the skin puncture. The median (IQR) gestational age of participants was 32 (29-37) weeks, and corrected gestational age at measurement was 33 (30-37) weeks. Cronbach's alpha for the five N-PASS-J items was 0.93. Pain and distress scores were significantly higher at the time of blood collection than at rest (mean ± SD) (baseline: 0.3 ± 0.6; skin puncture: 5.2 ± 2.4, F (1, 120) = 232.5, p < 0.0001). The correlation coefficient between the distress scores and the Face Scale for Pain Assessment Preterm Infant score was 0.91. CONCLUSIONS: The N-PASS-J is a dependable and valid instrument for assessing acute pain in infants with illness treated in the NICU.