Evaluation of the Reliability and Validity of the Behavioral Indicators of Infant Pain Scale in Chinese Neonates

Background: Behavioral Indicators of Infant Pain scale (BLIP) has been shown to be a good tool to assess pain in infants. Aims: This paper aimed to translate BLIP into Chinese and evaluate its reliability and validity for neonates in China. Design: A prospective observational study. Setting and Participants: A convenience sample of 396 neonates (preterm and term infants) were recruited from neonatal intensive care units in China from July to October 2016. Methods: The BLIP was translated and adjusted for semantic adaption.396 neonates were assessed during 3 phases of blood collection from an artery/vein. A video camera was positioned for a close-up view of the face and body. The neonates' pain was rated independently by 2 nurses who were trained and familiar with the Chinese version of BLIP (C-BlIP)and FLACC (Facial expression, Legs, Activity, Crying and Consolability). Results: The internal consistency were 0.904 (preterm) and 0.895 (term). The test-retest reliability were 0.947 (preterm) and 0.938 (term) and the interclass correlation coefficients were 0.921 to 0.959 (preterm) and 0.921 to 0.959 (term). The correlations between the C-BLIP and FLACC were high (preterm: r = 0.948, term: r = 0.896). Using the C-BLIP, the 3 phases of blood collection were found to be statistically different (preterm: F = 635.76, term: F = 675.54; P < 0.001), which showed that the construct validity of C-BLIP was good. Conclusion: The BLIP is a reliable and valid tool to assess pain in term and preterm neonates in China. (C) 2020 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.