Adaptation and validation of the EVENDOL scale to assess pain in neonates in Portuguese language

Abstract

BackgroundEVENDOL scale (from the French Evaluation Enfant Douleur) is used to evaluate pain in children in any situation covering a wider age group than other pain scales (birth up to seven years). This study aimed to evaluate pain in hospitalized newborns, to adapt and validate the EVENDOL to Brazilian Portuguese. Study designCross-sectional, cross-cultural adaptation and validation study in a convenience sample from a tertiary hospital, Brazil. EVENDOL was translated and tested for reliability and validity using the PIPP and NFCS scales for comparison. For reliability testing, two observers independently evaluated 117 nociceptive procedures from 87 newborns. Internal consistency coefficient Cronbach's alpha, internal class agreement coefficient, and Kappa factor were appropriately measured. ResultsThe scale's internal consistency reached a value of 0.82, and the estimates of internal consistency and reliability also reached acceptable or very good values. Two-way ANOVA determined statistically significant effect of gestational age on the total score of the EVENDOL (F = 4.14; p = 0.045), younger infants had the lowest values, as lower values of Apgar-5° minute lowered the indicator “Interaction with the Environment” (F = 5.066; p = 0.027). ConclusionsEVENDOL proved to be an easily applied tool and it was psychometrically robust, reliable and valid for use with both premature and term hospitalized newborns, who were clinically stable, being Apgar score and gestational age relevant factors. It is a reliable method of identifying pain in babies who need more support from the hospital staff and now is available for use in Portuguese language. Tweetable abstractThe EVENDOL pain scale is now validated for babies born at term and prematurely in Portuguese Language allowing its use in all Lusophone countries.