Adaptation and Initial Validation of the Premature Infant Pain Profile-Revised (PIPP-R) in Brazil

Abstract

Background: The use of reliable pain assessment measures is essential for scoring and managing pain in infants. The Premature Infant Pain Profile (PIPP) is reliable and valid and has been recently revised. To adapt and validate the PIPP-R into Portuguese and to evaluate its psychometric properties are required to ensure maintenance of meaning and content.

Aims: The aim of this study was to culturally adapt to Brazilian Portuguese and explore content validity and construct validity of the Premature Infant Pain Profile-Revised.

Design: This is a methodological study.

Participants/settings: Two existing data sets of randomized clinical trials previously conducted were used to examine initial construct validity of the prefinal version of the Premature Infant Pain Profile-Revised.

Methods: Cross-cultural adaptation and validation occurred in four steps. Independent versions of the Premature Infant Pain Profile-Revised were produced, followed by the preparation of a synthetic version. Two back-translated versions were realized by professional translators. An expert committee evaluated idiomatic and semantic equivalence and clarity and relevance of the items. A content validity index was calculated. Finally, a consolidated prefinal version in Portuguese was then produced.

Results: No difficulties in producing the material were reported. Semantic and idiomatic aspects were considered adequate, and content validity index was 1.0. Premature Infant Pain Profile and Premature Infant Pain Profile-Revised scores were highly correlated for pain after heel lancing and venipuncture (R² = 0.986, p < .001) and for pain associated with analgesic strategies (R² = 0.966-1.00, p < .001).

Conclusions: The Premature Infant Pain Profile-Revised was culturally adapted into Brazilian Portuguese. Appropriate content validity index was determined. Evidence of construct validity was also found. Future studies are warranted to explore the feasibility and other psychometric properties of using the Premature Infant Pain Profile-Revised translated and adapted into Brazilian Portuguese in the clinical setting.