Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
Department of Anesthesiology, Erasmus MC, Rotterdam, The Netherlands.
Pain Pract. 2019 Apr;19(4):407-417. doi: 10.1111/papr.12756. Epub 2019 Jan 13.
The Rotterdam Elderly Pain Observation Scale (REPOS) has been proven useful to assess pain in noncommunicative and cognitively impaired nursing home residents. We evaluated whether the REPOS is also reliable and valid for pain assessment in the hospital setting.
In this prospective multicenter observational study, surgical patients were observed perioperatively at bedside and internal medicine patients were filmed during a possible painful moment and at rest. Pain behavior was assessed from the video recordings with the REPOS and the Pain Assessment Checklist for seniors with Severe Dementia-Dutch language (PACSLAC-D). Longitudinal associations between REPOS score and numeric rating scale pain ratings from observers and nurses (NRS and NRS ) corrected for patients' gender were assessed with linear mixed models.
In total, 72 patients were included; 118 observations of surgical and 68 observations of internal medicine patients were analyzed. Interobserver reliability between the researcher and 2 other observers was good, with Cohen's kappa values of 0.71 (confidence interval [CI] 0.59 to 0.83) and 0.84 (CI 0.74 to 0.94), respectively. The intraobserver reliability of the principal investigator was good, with Cohen's kappa 0.82 (CI 0.67 to 0.91). Linear mixed modeling revealed correlation values between the REPOS and NRS of 0.67 and the REPOS and NRS of 0.73. Optimal sensitivity (78%) and specificity (90%) for the detection of pain were found with a REPOS cutoff score of ≥3, using an NRS score of ≥4 as the reference value.
The REPOS is reliable and valid for the assessment of postoperative and chronic pain in hospital patients who cannot self-report pain.
Rotterdam 老年疼痛观察量表（REPOS）已被证明可用于评估非沟通和认知障碍的养老院居民的疼痛。我们评估了 REPOS 用于评估医院环境中的疼痛是否也可靠和有效。
在这项前瞻性多中心观察性研究中，手术患者在手术期间进行床边观察，内科患者在可能出现疼痛时刻和休息时进行拍摄。从视频记录中使用 REPOS 和老年人严重痴呆疼痛评估检查表-荷兰语版（PACSLAC-D）评估疼痛行为。使用线性混合模型评估 REPOS 评分与观察者和护士的数字评定量表疼痛评分（NRS 和 NRS ）之间的纵向关联，其中 NRS 和 NRS 已校正患者的性别。
共纳入 72 例患者；分析了 118 例手术患者和 68 例内科患者的观察结果。研究人员与其他 2 名观察者之间的观察者间可靠性良好，Cohen's kappa 值分别为 0.71（置信区间[CI] 0.59 至 0.83）和 0.84（CI 0.74 至 0.94）。主要研究者的观察者内可靠性良好，Cohen's kappa 值为 0.82（CI 0.67 至 0.91）。线性混合模型显示，REPOS 与 NRS 的相关系数为 0.67，REPOS 与 NRS 的相关系数为 0.73。当使用 NRS 评分≥4 作为参考值时，REPOS 截断评分≥3 可检测疼痛的灵敏度（78%）和特异性（90%）最佳。
REPOS 可用于评估无法自述疼痛的住院患者的术后和慢性疼痛，其可靠性和有效性良好。
