Development of a labour pain assessment instrument

Abstract

Labour may impose severe pain, yet women experience the intensity of pain differently. The severity of labour pain is frequently underestimated by women, midwives and clinicians. Pain assessment is considered the key to labour pain measurement and a standardised instrument can assist with adequate management of labour pain. Although a variety of pain assessment/measurement tools were found by a search conducted between 2000 and 2010, the tool charts are detailed and require time to complete, they do not cover all aspects of labour, and they avoid quantifying and documentation of labour pain. Developing a new multidimensional labour pain assessment instrument could assist midwives and clinicians with labour pain control. Ethical permission was obtained from the university Faculty Academic Ethics Committee to develop a new labour pain assessment instrument. Six steps of Blackburn and Waite (2006:134) guided development of the instrument that measures pain during the first stage of labour. This exploratory sequential mixed method study, using a qualitative and quantitative research design, described the development process of the new instrument. Four focus groups with four to six members comprising midwifery lecturers, midwives working in the private and public hospitals, midwives in private practice and obstetricians were conducted to develop the instrument. The instrument was thereafter given in two Delphi technique rounds to the most senior persons teaching Midwifery at all South African universities to verify the content and structure of the instrument. Data analysis of the focus groups followed the steps of data reduction, data display and verification as proposed by Miles and Huberman (1994:428–444) and the mean ratings of the Likert scale as determined by the university was presented in tables. The trustworthiness and validity and reliability (truth value) of the instrument were supported by using multiple types of data to develop the instrument. The focus group members and Delphi experts expressed their enthusiasm and appraisement for a new labour pain assessment instrument. A sense of closure (saturation) was attained and the experts concluded that the instrument was ready to be tested.