Study On The Reliability And Validity Of Chinese Version Of Behavioral Indicators Of Infant Pain(C-BIIP)

Objective:In order to provide the basis for the establishment of neonatal pain assessment,this paper is to translate the Behavioral Indicators of Infant Pain(BIIP)into Chinese and evaluate the reliability and validity of the Behavioral Indicators of Infant Pain of Chinese version for neonates in China.It is also to explore the feedback of using Chinese version of Behavioral Indicators of Infant Pain after one month to detect the applicability and provide a good tool for neonatal pain assessment.Methods:After receiving the permission of the Behavioral Indicators of Infant Pain's author,we translated the scale into Chinese.The Chinese version of BIIP was translated from the original,back-translated and adjusted for semantic adaption.Then,396 neonates(197 preterm infants and 199 term infants)were assessed during 3Phases of blood collection for artery/ vein,30 seconds before the procedure,two minutes during and one minute after the procedure in Neonatal Intensive Care Unit(NICU)of 3 tertiary hospitals in Zhejiang province from July 2016 to October 2016.And a video camera was positioned for a close-up view of the face and body.The neonates' pain were rated independently by two nurses who were trained and appraised with the Chinese version of BIIP and FLACC.Finally,Nurses were asked to fill in a questionnaire after assessing neonates' pain for nursing quality improvement by using C-BIIP in NICU for one month.The data were analysed by SPSS17.0.The reliability and validity of the scale were calculated and evaluated,and clinical practicability of C-BIIP was evaluated.Result:(1)The result of the reliability : The Internal Consistency Cronbach's a coefficient was 0.904(preterm)?0.895(term).The Test-retest Reliability was 0.947(preterm)?0.938(term)and Interclass Correlation Coefficients was 0.921—0.959(preterm)?0.921—0.959(term).(2)The result of the validity:The Content validity was excellent which I-CVI was 1;S-CVI was 1.The semantic adaption was good.The correlations between the C-BIIP and FLACC were high(preterm:r=0.948,term:r=0.896).Two common factors were extracted with cumulative contribution rate of 77.740%(preterm)and 80.876%(term),which demonstrated a good constructive validity.The loading of each item on the corresponding factors was higher than 0.4.Using the C-BIIP to assess the 3 Phases of blood collection for artery/ vein,comparison of the three results were statistically different(preterm:F=635.76,term:F=675.54;P<0.001)which showed that the sensitivity of C-BIIP was good.(3)59.1% of respondents believed that the application of C-BIIP could not be time-consuming and half of the respondents could complete the pain assessment by this scale in 1 minute.More than 90% of respondents thought that C-BIIP was easy to master and the operation was good and 81.8% of respondents believed that C-BIIP was easy to use.77.3% of respondents believed this scale could effectively reflect the pain and the sensitivity was good.86.4% of respondents were quite willing to use this scale to assess neonates in their clinical practice.In addition,the respondents thought that the most important influence factor of using C-BIIP in the clinical was "the lack of policies in hospitals and the departments"(72.7%).The second factor was "the lack of training"(63.6%).Conclusion: The Chinese version of BIIP is a valid scale that is concise and easily interpreted.This scale has been shown to be a reliable,valid scale for assessing procedural pain in neonates in the NICU.C-BIIP is simple to understand,easy to use,less time-consuming and easy to be accepted by NICU nurses,It can be used in clinical practice to improve the quality of pain management.