Sulla Francesco, De Souza Ramos Nilson, Terzi Noemi, Trenta Tania, Uneddu Mariella, Zaldivar Cruces Melanny Alessandra, Sarli Leopoldo
Parma University, Parma, Italy.
Acta Biomed. 2017 Nov 30;88(5S):48-54. doi: 10.23750/abm.v88i5-S.6858.
Pain in intensive care units (ICUs) is a frequent and often undermanaged problem. Brain-injured patients are often unable to reliably self-report their pain, calling forth the need to use behavioural scales such as the Critical-Care Pain Observation Tool (CPOT). This study aimed to test the reliability and validity of the Italian CPOT use with brain-injured ICU adults.
A sample of 50 adults critical care patients was included. Each patient was assessed by two independent observers at three predefined times - at rest; during mobilization for hygiene; 20 minutes later - using the CPOT, PAINAD, and NRS.
A good correlation was found between independent observers scores during painful procedure, establishing interrater reliability of CPOT. Criterion validation was supported by a strong correlation between CPOT and PAINAD scores, and a moderate relation between CPOT and NRS scores. The CPOT was able to discriminate between patients undergoing painful versus non-painful procedures. However, PAINAD performed better in this sample, as revealed by the comparison between the two AUC of ROC curves.
The Italian CPOT use was found reliable and valid in this patient group.
重症监护病房（ICU）中的疼痛是一个常见且常常未得到妥善处理的问题。脑损伤患者往往无法可靠地自我报告疼痛，因此需要使用诸如重症监护疼痛观察工具（CPOT）等行为量表。本研究旨在测试意大利版CPOT在成年ICU脑损伤患者中使用的可靠性和有效性。
纳入50例成年重症监护患者样本。由两名独立观察者在三个预定义时间对每位患者进行评估——休息时；进行卫生护理活动时；20分钟后——使用CPOT、疼痛评估量表（PAINAD）和数字评分量表（NRS）。
在疼痛操作过程中，独立观察者评分之间发现了良好的相关性，确立了CPOT的评分者间信度。CPOT与PAINAD评分之间的强相关性以及CPOT与NRS评分之间的中度相关性支持了标准效度。CPOT能够区分接受疼痛与非疼痛操作的患者。然而，正如ROC曲线的两个AUC之间的比较所示，在该样本中PAINAD表现更好。
在该患者群体中，发现意大利版CPOT的使用是可靠且有效的。
