Buttes Paul, Keal Ginger, Cronin Sherill Nones, Stocks Laurel, Stout Cheryl
Paul Buttes, MSN, RN, CNML, is nurse manager at Baptist Health Louisville, Kentucky. Ginger Keal, BSN, RN, CNML, is nurse manager at Baptist Health Louisville, Kentucky. Sherill Nones Cronin, PhD, RN, BC, is professor of nursing at Bellarmine University, Kentucky. Laurel Stocks, MSN, APRN, RN, CCNS, is nurse practitioner at University of Louisville Healthcare, Kentucky. Cheryl Stout, MSN, RN, CENP, nursing director at Baptist Health Louisville, Kentucky.
Dimens Crit Care Nurs. 2014 Mar-Apr;33(2):78-81. doi: 10.1097/DCC.0000000000000021.
Effective management of pain begins with accurate assessment of its presence and severity, which is difficult in critically ill patients. The Critical-Care Pain Observation Tool (CPOT) was developed to evaluate behaviors associated with pain and validated primarily with cardiac surgical patients.
The purpose of this study was to examine reliability and validity of the CPOT in a general population of adult, critically ill patients.
Using a sample of 75 patients from critical care units of a community hospital, pain was evaluated at 3 times (prerepositioning, during repositioning, and postrepositioning) by 2 evaluators, using 3 different pain scales: CPOT; Faces, Legs, Activity, Cry, and Consolability (FLACC) scale; and Pain Intensity Numeric Rating Scale.
Results indicated that reliability and validity of the CPOT were acceptable. Interrater reliability was supported by strong intraclass correlations (ranging from 0.74 to 0.91). For criterion-related validity, significant associations were found between CPOT scores and both FLACC (0.87-0.92) and Pain Intensity Numeric Rating Scale (0.50-0.69) scores. Discriminant validity was supported by significantly higher scores during repositioning (mean, 1.85) versus at rest (pre mean, 0.60; post mean, 0.65).
The CPOT is an acceptable behavioral pain assessment scale for use in the general critical care patient population and is more appropriate for use with adults than the FLACC.
疼痛的有效管理始于对其存在和严重程度的准确评估，而这在重症患者中颇具难度。重症监护疼痛观察工具（CPOT）旨在评估与疼痛相关的行为，并且主要在心脏外科手术患者中得到了验证。
本研究旨在检验CPOT在成年重症患者总体人群中的可靠性和有效性。
从一家社区医院的重症监护病房选取75名患者作为样本，由2名评估者在3个时间点（重新摆放体位前、重新摆放体位期间和重新摆放体位后）使用3种不同的疼痛量表对疼痛进行评估：CPOT；面部、腿部、活动、哭闹和安慰度（FLACC）量表；以及疼痛强度数字评定量表。
结果表明CPOT的可靠性和有效性是可接受的。类内相关系数较高（范围为0.74至0.91），支持了评估者间信度。对于与标准相关的效度，发现CPOT评分与FLACC评分（0.87 - 0.92）和疼痛强度数字评定量表评分（0.50 - 0.69）之间均存在显著关联。重新摆放体位期间的评分（均值为1.85）显著高于静息时（重新摆放体位前均值为0.60；重新摆放体位后均值为0.65），支持了区分效度。
CPOT是一种可接受的用于普通重症监护患者人群的行为疼痛评估量表，与FLACC相比，它更适合用于成年人。
