Ribeiro Caíque Jordan Nunes, Araújo Andra Carla Santos de, Brito Saulo Barreto, Dantas Daniele Vieira, Nunes Mariangela da Silva, Alves José Antonio Barreto, Ribeiro Maria do Carmo de Oliveira
Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
Departamento de Enfermagem, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
Rev Bras Ter Intensiva. 2018 Mar;30(1):42-49. doi: 10.5935/0103-507x.20180009.
To evaluate the validity and reliability of the Brazilian version of the Behavioral Pain Scale (BPS-Br) in victims of traumatic brain injury.
Observational prospective study with paired and repeated measures conducted at two intensive care units (clinical and surgical) of a large general hospital. The convenience sample consisted of adult victims of moderate or severe penetrating or blunt craniocerebral trauma who were sedated and mechanically ventilated. A total of 432 paired observations were performed by independent evaluators simultaneously, prior to eye cleaning, during eye cleaning, during tracheal aspiration and after tracheal aspiration. Sociodemographic, clinical, trauma-related, sedoanalgesia and physiological parameter data (heart rate, systolic and diastolic blood pressure) were collected. The discriminant validity was tested using the Friedman and Wilcoxon paired tests. The intraclass correlation coefficient and Cohen's Kappa coefficient were used to evaluate the reliability. The Spearman correlation test was used to test the association between clinical variables and BPS-Br scores during tracheal aspiration.
There was a significant increase in the physiological parameters during tracheal aspiration, but without correlation with the BPS-Br scores. Pain was significantly more intense during tracheal aspiration (p < 0.005). Satisfactory interobserver agreement was found, with an intraclass correlation coefficient of 0.95 (0.90 - 0.98) and Kappa coefficient of 0.70.
Brazilian version of the Behavioral Pain Scale scores increased during tracheal aspiration. The Brazilian version of the scale was valid and reliable for pain assessment of traumatic brain injury victims undergoing tracheal aspiration.
评估巴西版行为疼痛量表（BPS-Br）在创伤性脑损伤患者中的有效性和可靠性。
在一家大型综合医院的两个重症监护病房（临床和外科）进行配对和重复测量的观察性前瞻性研究。便利样本包括中度或重度穿透性或钝性颅脑外伤的成年患者，这些患者接受了镇静和机械通气。独立评估者在眼部清洁前、眼部清洁期间、气管吸引期间和气管吸引后同时进行了总共432次配对观察。收集了社会人口统计学、临床、创伤相关、镇静镇痛和生理参数数据（心率、收缩压和舒张压）。使用Friedman和Wilcoxon配对检验来测试判别效度。使用组内相关系数和Cohen's Kappa系数来评估可靠性。使用Spearman相关检验来测试气管吸引期间临床变量与BPS-Br评分之间的关联。
气管吸引期间生理参数显著增加，但与BPS-Br评分无关。气管吸引期间疼痛明显更强烈（p < 0.005）。观察者间一致性良好，组内相关系数为0.95（0.90 - 0.98），Kappa系数为0.70。
巴西版行为疼痛量表评分在气管吸引期间增加。该量表的巴西版对于接受气管吸引的创伤性脑损伤患者的疼痛评估是有效且可靠的。
