Azevedo-Santos Isabela F, Alves Iura G N, Badauê-Passos Daniel, Santana-Filho Valter J, DeSantana Josimari M
Federal University of Sergipe, Aracaju, SE, Brazil.
Department of Physical Therapy, Federal University of Sergipe, Aracaju, SE, Brazil.
Pain Pract. 2016 Apr;16(4):451-8. doi: 10.1111/papr.12287. Epub 2015 Apr 10.
Pain assessment in Intensive Care Units (ICU) can be performed based on validated instruments as the Behavioral Pain Scale (BPS). Despite the existence of this clinical score, there is no Brazilian version of it to assess critically ill patients. This study aimed to translate the BPS into Brazilian Portuguese, verify its psychometric properties (reliability, validity, and responsiveness) and the correlation between pain measured and heart rate (HR), blood pressure (BP), Ramsay, and RASS scores.
Pain intensity by using Brazilian BPS version, HR, and BP were observed by 2 investigators during 3 different moments: at rest; during eye cleaning (EC); and tracheal suctioning (TS) in 15 adult subjects sedated and mechanically ventilated. Sedation level, severity of disease, and use of sedatives and analgesic drugs were also recorded.
There was a high responsiveness coefficient (coefficient = 1.72) and pain was significantly higher during tracheal suctioning (P ≤ 0.003) and eye cleaning (P ≤ 0.04) than at rest. It was evidenced a low reliability and no significant correlation between translated BPS scores and physiological parameters during tracheal suctioning, sedation scales, flow of the sedatives drugs, or with the general health status (P > 0.07).
Brazilian BPS has high responsiveness and capacity to detect pain intensity in different situations in the ICU routine. This preliminary study proved the feasibility and importance of valid this scale in Brazil in order to improve critically ill patients care.
重症监护病房（ICU）的疼痛评估可基于经过验证的工具，如行为疼痛量表（BPS）进行。尽管存在这种临床评分，但尚无巴西版本用于评估重症患者。本研究旨在将BPS翻译成巴西葡萄牙语，验证其心理测量特性（信度、效度和反应度）以及所测疼痛与心率（HR）、血压（BP）、拉姆齐评分和RASS评分之间的相关性。
2名研究人员在3个不同时刻观察15名接受镇静和机械通气的成年受试者使用巴西版BPS的疼痛强度、HR和BP：休息时；眼部清洁（EC）期间；气管抽吸（TS）期间。还记录了镇静水平、疾病严重程度以及镇静剂和镇痛药的使用情况。
反应度系数较高（系数 = 1.72），气管抽吸期间（P≤0.003）和眼部清洁期间（P≤0.04）的疼痛明显高于休息时。结果表明，翻译后的BPS评分与气管抽吸期间的生理参数、镇静量表、镇静药物流量或总体健康状况之间可靠性较低且无显著相关性（P>0.07）。
巴西版BPS在ICU常规中具有较高的反应度和检测不同情况下疼痛强度的能力。这项初步研究证明了在巴西验证该量表以改善重症患者护理的可行性和重要性。
