NEONATAL INFANT PAIN SCALE: CROSS-CULTURAL ADAPTATION AND VALIDATION TO BRAZIL Cross-Cultural Adaptation of NIPS

The Neonatal Infant Pain Scale (NIPS) was initially developed in Canada and, although it has been previously used in Brazil, the scale has not been adequately adapted and validated for use in the country. Therefore, the goal of the present study was to perform the cross-cultural adaptation and clinical validation of the NIPS for use in the Brazilian population. The instrument was adapted based on the method outlined by Beaton et al., including the production and combination of translated versions, back-translation, committee review and pilot testing. The psychometric properties of the adapted instrument, including its validity, reliability and internal consistency, were then evaluated in a clinical validation study. The sample consisted of 60 at-term newborns who were evaluated by six nurses as they experienced vaccination. The psychometric properties of the scale were evaluated using Student’s t-tests, prevalence-adjusted bias-adjusted kappa (PABAK) scores, the BlandAltman method and Cronbach’s alpha coefficients. The Brazilian version of the NIPS was named the Escala de Dor no Recém-Nascido (NIPS-Brazil), and demonstrated excellent interand intraobserver reliability. Total NIPS-Brazil scores yielded PABAK scores of 0.93, while the Bland-Altman method revealed interand intraobserver reliability values of 95% and 90%, respectively. The NIPS-Brazil had adequate internal consistency, as evidenced by a Cronbach’s alpha of 0.762. The NIPS was successfully adapted for use in Brazil, and is now available for use in the assessment of acute pain in at-term newborns in Brazil.