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.