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Pain Assessment and Measurement in Neonates: An Updated Review

Cong, Xiaomei PhD, RN; McGrath, Jacqueline M. PhD, RN, FNAP, FAAN; Cusson, Regina M. PhD, NNP-BC, APRN, FAAN; Zhang, Di MS, RN

Section Editor(s): Ikuta, Linda RN, MN, CCNS, PHN

doi: 10.1097/ANC.0b013e3182a41452
Foundations in Newborn Care

Pain assessment and measurement are the cornerstones of pain management. Pain assessment connotes a comprehensive multidimensional description. Conversely, pain measurement provides a numeric quantitative description of each factor illustrating pain qualities. Pain scales provide a composite score used to guide practice and research. The type of infant pain instrument chosen is a significant factor in guiding pain management practice. The purpose of this review was to summarize current infant pain measures by introducing a conceptual framework for pain measurement. Although more than 40 infant pain instruments exist, many were devised solely for research purposes; several of the newly developed instruments largely overlap with existing instruments. Integration of pain management into daily practice remains problematic. Understanding how each instrument measures infant pain allows clinicians to make better decisions about what instrument to use with which infant and in what circumstances. In addition, novel new measurement techniques need further testing.

School of Nursing, University of Connecticut, Storrs (Drs Cong, McGrath, and Cusson and Ms Zhang); and Connecticut Children's Medical Center, Hartford (Dr McGrath).

Correspondence: Xiaomei Cong, PhD, RN, University of Connecticut, School of Nursing, 231 Glenbrook Rd, Storrs, CT 06269 (

The authors declare no conflict of interest.

© 2013 by The National Association of Neonatal Nurses