Initial validation of the Behavioral Indicators of Infant Pain (BIIP)

Holsti L, Grunau R,

This article describes a scale for measuring pain in infants by observing behavioual characteristcs such as hand movements and specific facial expression components. Changes in heart rate and oxygen saturation are also considered in an attempt to assess this most challanging of symptoms.

The validity of the scale was asessed in a NICU setting where, the author argues is a vital place to understand levels of infant pain in order to optimise outcomes. The scale was compaired to the Neonatal Infant Pain Scale (NIPS) described by Lawrence et al 1993. Heart rate was also measured by continuous electrocardiographic activity.

Ninety two infants were assessed during blood collection procedures. The study found the scale to be reliable and valid in this population.

The authors go on to discus the benifits of this scale over already existing measures including the idea that the BIIP is one of the first scales to be based on scientific theory. The article also discusses the dilemma that many children in intensive care situations has central or peripheral nerve involvements which may effect behavioural based pain scales.

Pain 132 (2007) 264–272

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