Ingram School of Nursing, McGill University, Montreal, Quebec, Canada H3A 2A7.
Semin Respir Crit Care Med. 2013 Apr;34(2):153-68. doi: 10.1055/s-0033-1342970. Epub 2013 May 28.
A valid pain assessment is the foundation of adequate pain management. Pain assessment can be challenging, especially in adult intensive care unit (ICU) patients who are unable to self-report. In such situations, relying on observational assessment tools is an alternative strategy. This review describes and analyzes the development and psychometric properties of pain assessment tools developed for use with nonverbal critically ill adults. A total of 32 relevant papers that described the psychometric properties of eight pain assessment tools were included. The scale development process, psychometric properties (i.e., reliability and validity), and feasibility of pain assessment tools were analyzed using a 0 to 20 scoring system. Each pain assessment tool was scored independently by two reviewers. Of the eight behavioral pain scales developed for use in adult ICU patients, the Behavioral Pain Scale (BPS) and the Critical-Care Pain Observation Tool (CPOT) are considered to be the most valid and reliable for this purpose, according to the available evidence. Behavioral pain scales may be viable alternatives to assessing pain in ICU patients who are unable to self-report, but only valid, reliable, and feasible scales should be used for this purpose.
有效的疼痛评估是充分疼痛管理的基础。疼痛评估具有一定挑战性，尤其是对于无法自我报告的成年重症监护病房（ICU）患者而言。在这种情况下，依赖观察评估工具是一种替代策略。本综述描述和分析了为非语言表达的重症成人患者设计的疼痛评估工具的开发和心理计量学特性。共纳入了 32 篇相关文献，描述了 8 种疼痛评估工具的心理计量学特性。使用 0 至 20 的评分系统分析了疼痛评估工具的量表开发过程、心理计量学特性（即信度和效度）和可行性。两位评审员分别对每个疼痛评估工具进行了独立评分。在为成年 ICU 患者设计的 8 种行为疼痛量表中，根据现有证据，行为疼痛量表（BPS）和重症监护疼痛观察工具（CPOT）被认为是最有效和可靠的。对于无法自我报告的 ICU 患者，行为疼痛量表可能是评估疼痛的可行替代方法，但仅应使用有效、可靠且可行的量表来进行评估。
