Psychometric validation of the behavioral indicators of pain scale for the assessment of pain in mechanically ventilated and unable to self-report critical care patients

被引：25

作者：

Latorre-Marco, I. ^{[1
]}

Acevedo-Nuevo, M. ^{[1
]}

Solis-Munoz, M. ^{[2
]}

Hernandez-Sanchez, L. ^{[1
]}

Lopez-Lopez, C. ^{[3
]}

Sanchez-Sanchez, M. M. ^{[4
]}

Wojtysiak-Wojcicka, M. ^{[5
]}

de las Pozas-Abril, J. ^{[6
]}

Robleda-Font, G. ^{[7
]}

Frade-Mera, M. J. ^{[8
]}

De Blas-Garcia, R. ^{[9
]}

Gorgolas-Ortiz, C. ^{[10
]}

De la Figuera-Bayon, J. ^{[11
]}

Cavia-Garcia, C. ^{[12
]}

机构：

[1] Hosp Univ Puerta de Hierro Majadahonda, Med Intens Care Unit, Majadahonda, Spain

[2] Hosp Univ Puerta de Hierro Majadahonda, Res Area, Nursing & Healthcare, Majadahonda, Spain

[3] Hosp Univ Doce Octubre, Emergency & Trauma Intens Care Unit, Madrid, Spain

[4] Hosp Univ Getafe, Intens Care Unit, Getafe, Spain

[5] Hosp Univ Quiron Madrid, Intens Care Unit, Pozuelo De Alarcon, Spain

[6] Hosp Gen Univ Gregorio Maranon, Intens Care Unit, Madrid, Spain

[7] Hosp Univ Santa Creu & St Pau, Intens Care Unit, Barcelona, Spain

[8] Hosp Univ Doce Octubre, Intens Care Unit, Madrid, Spain

[9] Hosp Univ Puerta de Hierro Majadahonda, Postsurg Intens Care Unit, Majadahonda, Spain

[10] Hosp Univ Basurto, Postsurg Intens Care Unit, Bilbao, Spain

[11] Hosp Univ La Princesa, Intens Care Unit, Madrid, Spain

[12] Hosp Univ Cruces, Intens Care Unit, Baracaldo, Spain

来源：

MEDICINA INTENSIVA | 2016年 / 40卷 / 08期

关键词：

Critically ill patients; Pain assessment; Scale; Mechanical ventilation; Behavior; Reliability; Validity; OBSERVATION TOOL; ILL PATIENTS; UNIT; SEDATION; ANALGESIA; DELIRIUM; AGITATION; ADULT; IMPLEMENTATION; MULTICENTER;

D O I：

10.1016/j.medin.2016.06.004

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

OBJECTIVE: To assess the psychometric properties of the behavioral indicators of pain scale (ESCID) when applied to a wide range of medical and surgical critical patients. DESIGN: A multicentre, prospective observational study was designed to validate a scale measuring instrument. SETTING: Twenty Intensive Care Units of 14 hospitals belonging to the Spanish National Health System. PARTICIPANTS: A total of 286 mechanically ventilated, unable to self-report critically ill medical and surgical adult patients. PROCEDURE: Pain levels were measured by two independent evaluators simultaneously, using two scales: ESCID and the behavioral pain scale (BPS). Pain was observed before, during, and after two painful procedures (turning, tracheal suctioning) and one non-painful procedure. MAIN VARIABLES: ESCID reliability was measured on the basis of internal consistency using the Cronbach-alpha coefficient. Inter-rater and intra-rater agreement were measured. The Spearman correlation coefficient was used to assess the correlation between ESCID and BPS. RESULTS: A total of 4386 observations were made in 286 patients (62% medical and 38% surgical). High correlation was found between ESCID and BPS (r=0.94-0.99; p<0.001), together with high intra-rater and inter-rater concordance. ESCID was internally reliable, with a Cronbach-? value of 0.85 (95%CI 0.81-0.88). Cronbach-alpha coefficients for ESCID domains were high: facial expression 0.87 (95%CI 0.84-0.89), calmness 0.84 (95%CI 0.81-0.87), muscle tone 0.80 (95%CI 0.75-0.84), compliance with mechanical ventilation 0.70 (95%CI 0.63-0.75) and consolability 0.85 (95%CI 0.81-0.88). CONCLUSION: ESCID is valid and reliable for measuring pain in mechanically ventilated unable to self-report medical and surgical critical care patients. (C) 2016 The Authors. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license.

引用

页码：463 / 473

页数：11

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