Barzanji Arvin, Zareiyan Armin, Nezamzadeh Maryam, Mazhari Marjan Seyed
Nursing Faculty, AJA University of Medical Sciences, Tehran, Iran.
Department of Anesthesiology, Faculty of Paramedical, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Open Access Maced J Med Sci. 2019 Jan 23;7(3):446-457. doi: 10.3889/oamjms.2019.103. eCollection 2019 Feb 15.
Over 70% of patients hospitalised in an intensive care unit (ICU) often experience moderate to severe pain due to pre-existing diseases, trauma, surgery, aggressive procedures, and routine ICU care. Many patients hospitalised in ICU are not able to speak and express their pain due to various causes, including mechanical ventilation, reduced consciousness, and administration of sedative drugs. Therefore, the use of observational and behavioural pain tools is recommended in this group of patients given their inability to express pain.
To examine the existing observational and behavioural tools for assessment of in Nonverbal Intubated Critically Adult Patients after Open-Heart Surgery.
A systematic review of available observational and behavioural tools for assessment of pain was undertaken using the COSMIN checklist. A literature search was conducted using the following databases: Ovid, Science Direct, Scopus, PubMed, and CINHAL databases, Google Scholar search engine as well as Persian resources Sid, Magiran, Iran doc, and IranMedex up to the end of 2017 were reviewed.
A total of 47 studies that had examined five tools used in intensive care units after cardiac surgery in patients under mechanical ventilation were reviewed. Each of the five tools included behavioural and observational items, and only one tool had physiological items. All the tools had been evaluated regarding validity and reliability. In the three tools, sensitivity, specificity, responsiveness, and satisfaction were considered.
Based on available evidence and investigations, CPOT and BPS tools have good validity and reliability to be used in pain assessment in Nonverbal Intubated Critically Adult Patients after Open-Heart Surgery. The NVPS tool requires more studies to be further confirmed before the assessment of pain in this group of patients.
在重症监护病房（ICU）住院的患者中，超过70%常因既有疾病、创伤、手术、侵入性操作及常规ICU护理而经历中度至重度疼痛。许多在ICU住院的患者由于各种原因无法说话并表达疼痛，包括机械通气、意识减退和使用镇静药物。因此，鉴于这组患者无法表达疼痛，建议使用观察性和行为性疼痛评估工具。
研究用于评估心脏直视手术后成年非言语插管重症患者疼痛的现有观察性和行为性工具。
使用COSMIN清单对现有的用于疼痛评估的观察性和行为性工具进行系统评价。使用以下数据库进行文献检索：Ovid、Science Direct、Scopus、PubMed和CINHAL数据库，谷歌学术搜索引擎以及波斯语资源Sid、Magiran、Iran doc和IranMedex，检索截至2017年底的文献。
共回顾了47项研究，这些研究考察了机械通气患者心脏手术后在重症监护病房使用的五种工具。这五种工具均包含行为和观察项目，只有一种工具包含生理项目。所有工具均已针对有效性和可靠性进行了评估。在三种工具中，还考虑了敏感性、特异性、反应性和满意度。
基于现有证据和调查，CPOT和BPS工具在评估心脏直视手术后成年非言语插管重症患者疼痛方面具有良好的有效性和可靠性。NVPS工具在用于评估这组患者的疼痛之前，需要更多研究进一步证实。
