Clinics in perinatology
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Clinics in perinatology · Sep 2002
Clinical utility and clinical significance in the assessment and management of pain in vulnerable infants.
Pain in vulnerable populations unable to provide verbal report is challenging in terms of measurement and treatment. Clinicians strive to provide the best possible pain management for infants in the NICU, yet they are often hindered due to paucity of measures that are not only reliable and valid but also clinically useful. Clinical utility of measures is difficult to establish due to a lack of consistent definition of the construct, varied methods of determination, and the secondary importance afforded to this issue in relation to the establishment of reliability and utility. ⋯ The issue of defining the extent of change in pain scores that is clinically significant or important remains unclear. Clarity will involve assigning meaning to particular changes in pain scores for vulnerable infants across a broad array of situations and severities of pain. Although research on this topic in children and adults provides some guidance to this dilemma, only through innovative and creative methods will we be able to address these issues.