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Open Access Determining the Structure of Acute Pain Responses in Vulnerable Neonates Analyse de la structure des réponses à la douleur aiguë chez des nouveau-nés vulnérables

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The primary purpose was to determine the underlying structure of the vulnerable infant's response to an acute painful procedure. The secondary purpose was to explore the influence of context (e.g., risk for neurological impairment [NI] and gestational age [GA]). A descriptive cohort design determined contributions of selected indicators to the structure of infant pain. The magnitude of variance for 19 pain indicators was assessed using 3 exploratory factor analyses in 149 neonates. The basic exploratory factor structure included behavioural (e.g., facial actions) and physiological (e.g., oxygen saturation, heart rate) indicators. Facial actions accounted for the greatest variance across all factor solutions (29–39%). Physiological indicators explained 8 to 26% additional variance. There were no consistent differences in the factor structures when contextual factors were explored.

Le but principal du projet était de déterminer la structure sous-jacente de la réponse du nouveau-né vulnérable à une intervention causant une douleur aiguë. Son but secondaire était d'analyser l'influence du contexte (p. ex. risque d'affection neurologique [AN] et âge gestationnel [AG]). L'étude d'une cohorte descriptive a permis d'établir le rôle des indicateurs sélectionnés relativement à la structure de la douleur chez le nourrisson. On a effectué une analyse de variance sur 19 indicateurs de la douleur à l'aide de trois analyses factorielles chez 149 nouveau-nés. La structure factorielle préliminaire comprenait des indicateurs comportementaux (p. ex. mouvements faciaux) et physiologiques (p. ex. saturation en oxygène, fréquence cardiaque). Les mouvements faciaux ont obtenu la variance la plus élevée pour toutes les solutions factorielles (29-39 %). Les indicateurs physiologiques expliquent 8 à 26 % de la variance additionnelle. On n'a observé aucune différence systématique entre les structures factorielles dans l'analyse des facteurs contextuels.

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Document Type: Research Article

Publication date: 01 June 2007

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