Department of Intensive Care Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
Department of Intensive Care Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
J Crit Care. 2015 Feb;30(1):167-72. doi: 10.1016/j.jcrc.2014.09.007. Epub 2014 Sep 22.
The Behavioral Pain Scale (BPS) and Critical-Care Pain Observation Tool (CPOT) are behavioral pain assessment tools for uncommunicative and sedated intensive care unit (ICU) patients. This study compares the discriminant validation and reliability of the CPOT and the BPS, simultaneously, in mechanically ventilated patients on a mixed-adult ICU.
This is a prospective observational cohort study in 68 mechanically ventilated medical ICU patients who were unable to report pain.
The BPS and CPOT scores showed a significant increase of 2 points between rest and the painful procedure (turning). The median BPS scores between rest and the nonpainful procedure (oral care) showed a significant increase of 1 point, whereas the median CPOT score remained unchanged. The interrater reliability of the BPS and CPOT scores showed a fair to good agreement (0.74 and 0.75, respectively).
This study showed that the BPS and the CPOT are reliable and valid for use in a daily clinical setting. Although both scores increased with a presumed painful stimulus, the discriminant validation of the BPS use was less supported because it increased during a nonpainful stimulus. The CPOT appears preferable in this particular group of patients, especially with regard to its discriminant validation.
行为疼痛量表（BPS）和重症监护疼痛观察工具（CPOT）是用于无法交流和镇静的重症监护病房（ICU）患者的行为疼痛评估工具。本研究同时比较了 CPOT 和 BPS 在混合成人 ICU 中机械通气患者中的鉴别验证和可靠性。
这是一项针对 68 名无法报告疼痛的机械通气重症监护病房患者的前瞻性观察队列研究。
BPS 和 CPOT 评分在休息和疼痛过程（翻身）之间显示出显著增加 2 分。在休息和非疼痛过程（口腔护理）之间，BPS 评分中位数显著增加 1 分，而 CPOT 评分中位数保持不变。BPS 和 CPOT 评分的组内相关性显示出良好的一致性（分别为 0.74 和 0.75）。
本研究表明，BPS 和 CPOT 在日常临床环境中是可靠和有效的。尽管两个评分都随着假定的疼痛刺激而增加，但 BPS 使用的鉴别验证支持较少，因为它在非疼痛刺激期间增加。CPOT 在这群特殊患者中似乎更可取，特别是在其鉴别验证方面。
