Nazari Roghieh, Froelicher Erika Sivarjan, Nia Hamid Sharif, Hajihosseini Fatemeh, Mousazadeh Noushin
Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Physiological Nursing, School of Nursing and Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California, United States of America.
Indian J Crit Care Med. 2022 Summer;26(4):472-476. doi: 10.5005/jp-journals-10071-24154.
Pain assessment in unconscious patients is a major challenge for healthcare providers. This study aims to compare the diagnostic value of the critical-care pain observation tool (CPOT) and the behavioral pain scale (BPS) for pain assessment among unconscious patients.
This cross-sectional study was conducted in 2019. Forty-five unconscious patients were selected randomly from four general intensive care units (ICUs) in the north of Iran. The discriminant validity of CPOT and BPS were evaluated for pain during a nociceptive and a nonnociceptive procedure. For reliability assessment, interrater agreement was obtained using Lin's concordance correlation coefficient and weighted kappa coefficient.
Patients who had been hospitalized in ICU due to surgery or trauma (57.70%) or medical problems (42.30%) were studied. During the nociceptive procedure, the mean scores of CPOT and BPS and all their dimensions, except for the compliance with ventilator dimension, were significantly greater than the nonnociceptive procedure ( <0.05) although the effect size of both instruments was small (0.32 vs 0.18). The Lin's concordance correlation coefficient in nonnociceptive and nociceptive procedures was respectively 0.67 and 0.62 for CPOT and 0.74 and 0.88 for BPS.
CPOT and BPS have acceptable discriminant validity in differentiating nonnociceptive and nociceptive procedural pain although the effect size of CPOT is larger than that of BPS. Although both instruments have low reliability, the reliability of BPS is better.
Nazari R, Froelicher ES, Nia HS, Hajihosseini F, Mousazadeh N. Diagnostic Values of the Critical Care Pain Observation Tool and the Behavioral Pain Scale for Pain Assessment among Unconscious Patients: A Comparative Study. Indian J Crit Care Med 2022;26(4):472-476.
对医护人员而言，评估昏迷患者的疼痛是一项重大挑战。本研究旨在比较危重症疼痛观察工具（CPOT）和行为疼痛量表（BPS）在昏迷患者疼痛评估中的诊断价值。
本横断面研究于2019年开展。从伊朗北部四个综合重症监护病房（ICU）中随机选取45例昏迷患者。在伤害性和非伤害性操作过程中，对CPOT和BPS在疼痛方面的判别效度进行评估。为评估可靠性，采用林氏一致性相关系数和加权kappa系数获得评分者间的一致性。
研究对象为因手术或创伤（57.70%）或医疗问题（42.30%）入住ICU的患者。在伤害性操作过程中，CPOT和BPS及其所有维度（除呼吸机顺应性维度外）的平均得分均显著高于非伤害性操作（P<0.05），尽管两种工具的效应量都较小（分别为0.32和0.18）。在非伤害性和伤害性操作过程中，CPOT的林氏一致性相关系数分别为0.67和0.62，BPS分别为0.74和0.88。
CPOT和BPS在区分非伤害性和伤害性操作疼痛方面具有可接受的判别效度，尽管CPOT的效应量大于BPS。虽然两种工具的可靠性都较低，但BPS的可靠性更好。
Nazari R, Froelicher ES, Nia HS, Hajihosseini F, Mousazadeh N. 危重症疼痛观察工具和行为疼痛量表在昏迷患者疼痛评估中的诊断价值：一项比较研究。《印度重症医学杂志》2022；26(4):472 - 476。
