Psychometric Evaluation of the Neonatal Pain, Agitation, and Sedation (N-PASS) Scale In Infants and Children Up to Age 36 Months
The purpose of this study was to investigate the Neonatal Pain, Agitation, and
Sedation Scale (N-PASS) tool for evidence of validity and reliability in infants and
children aged 1 to 36 months in the postoperative recovery period. The design
was a prospective, nonexperimental psychometric evaluation. The sample analyzed
was composed of 40 subjects aged 1 to 36 months. Data were collected
by evaluating participants every 5 minutes, scoring the N-PASS sedation subscale
along with the University of Michigan Sedation Scale (UMSS) and the NPASS
pain/agitation subscale along with the Face, Legs, Arms, Cry, Consolability
(FLACC) tool. The results showed that the Cronbach’s alphas of the N-PASS
sedation scale ranged from 0.853 to 0.923, and from 0.935 to 0.971 for the NPASS
pain/agitation scale. Correlations between the N-PASS sedation scale and
the UMSS tool ranged from 0.847 to 0.967. Correlations between the N-PASS
pain/agitation scale and the FLACC tool ranged from 0.980 to 0.996. Repeated
measures ANOVA analysis revealed that the N-PASS sedation score decreased
linearly over time, and that N-PASS pain/agitation scores changed erratically
over time. Regression analysis revealed a statistically nonsignificant linear trend
for the prediction of amount of time spent in the recovery area. Principal axis factor
analysis found that two factors accounted for 80.46% to 87.77% of the variance.
One factor represented pain/agitation, the other sedation, confirming the
two subscales of the N-PASS tool. All items had high factor loadings (> 0.60).
Factor structure remained similar over time. The implications for this research
indicate sufficient evidence for the use of the N-PASS tool for sedation and
pain/agitation assessment in infants and children age 1 to 36 months.