Evidence map›Paper›PMID 32555012›Full record

ArticleNursing research

Behavioral Observation of Infants With Life-Threatening or Life-Limiting Illness in the Neonatal Intensive Care Unit.

Christine A Fortney, Stephanie D Sealschott, Rita H Pickler

Open access · greenAbstract read
In one paragraph

Article in Nursing research. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Clinical rating scales for assessing pain in newborn infants.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Christine A FortneyChristine A. Fortney, PhD, RN, is Assistant Professor, Martha S. Pitzer Center for Women, Children and Youth, The Ohio State University College of Nursing, Columbus. Stephanie Sealschott, MS, RN, is Doctoral Candidate, The Ohio State University College of Nursing, Columbus. Rita Pickler, PhD, RN, FAAN, is FloAnn Sours Easton Professor of Child and Adolescent Health, The Ohio State University College of Nursing, Columbus.
Stephanie D Sealschott
Rita H Pickler
Office of the Director · USOhio Department of Health · US

Funding

Training in the Science of Health DevelopmentT32NR014225 · NINR · OHIO STATE UNIVERSITY · PI MARY E HAPP, Rita H Pickler · 2013 to 2026
$2.6M
Infant symptoms in the NICU: Impact on parent decision-making, coping, and distressK23NR016033 · NINR · OHIO STATE UNIVERSITY · PI FORTNEY, CHRISTINE A · 2016 to 2018
$406k
NINR NIH HHS K23 NR016033NINR NIH HHS T32 NR014225
6 · The paper itself

Abstract

backgroundInfants in the neonatal intensive care unit experience aversive stimuli that cause pain and distress. Maintaining adequate relief from pain and distress is challenging because of infants' varying ages and stages of development and their nonverbal status. Thus, pain and distress must be interpreted by a healthcare provider or other proxy from their own observations or perceptions. There is no standard research or clinical measure for pain and distress in infants.

objectiveThe purpose of this analysis was to evaluate the use of the COMFORT Behavior (COMFORT-B) Scale as a measure of pain and distress in infants diagnosed with life-threatening or life-limiting illnesses in the neonatal intensive care unit in comparison with the nurse-documented Neonatal Pain, Agitation and Sedation Scale; the infants' Technology Dependence Scale; and the mothers' report of total perceived symptom scores.

methodsInfants diagnosed with life-threatening or life-limiting illnesses and hospitalized in a Level IV neonatal intensive care unit in the Midwestern United States and their parents were included. Measurement of pain and distress in infants was collected weekly from enrollment through 12 weeks or until discharge, whichever occurred first. Observations for the COMFORT-B Scale were conducted before and after standard caregiving activities. Pearson r correlations were used to compare means between pain and distress, technology dependence, and mothers' total perceived symptom scores over time.

resultsData from 78 infants (46 male and 32 female infants) of ages 23-41 weeks of gestation at birth were analyzed. No correlations were found among the COMFORT-B Scale; the Neonatal Pain, Agitation and Sedation Scale; and mothers' total perceived symptom scores. Moderate correlations were found among the Technology Dependence Scale; mothers' total perceived symptom scores; and the Neonatal Pain, Agitation and Sedation Scale. DISCUSSION: Performing COMFORT-B observations can be challenging, and it is unclear whether the information obtained from the COMFORT-B Scale added to the assessment of the infant's pain and distress that is typically recorded in the health record or from parents. Further evaluation is needed to determine if it is more reliable to collect the Neonatal Pain, Agitation and Sedation Scale scores rather than conduct observations using the COMFORT-B Scale in studies of infants with life-threatening and life-limiting illnesses in the neonatal intensive care unit.

Indexed as

Critical IllnessBehavior Observation TechniquesFemaleHumansInfantInfant, NewbornIntensive Care Units, NeonatalMaleMidwestern United StatesPsychometrics

Identifiers

PMID32555012
PMCPMC7709877
OpenAlexW3036137045

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.