대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
권호 표지
DOI QR코드

DOI QR Code

중환자 통증사정을 위한 한국어판 Critical care Pain Observation Tool (CPOT)의 신뢰도 및 타당도 검증

Validation of a Korean translated version of the Critical Care Pain Observation Tool (CPOT) for ICU patients

  • 투고 : 2011.04.13
  • 심사 : 2012.02.05
  • 발행 : 2012.02.29
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The purpose of this methodological study was to examine the reliability and validity of a translated Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. Methods: A cross-sectional study design was used. Data were collected from a convenience sample of 202 critically ill patients admitted to a university hospital. Upon establishment of content and translation equivalence between the English and Korean version of CPOT, psychometric properties were evaluated. Results: The interrater reliability was found to be acceptable with the weighted kappa coefficients of .81-.88. Significant high correlations between the CPOT and the Checklist of Nonverbal Pain Indicators were found indicating good concurrent validity (r=.72-.83, p<.001). Data showed the area under the ROC curve of 0.86 with a cut-off point of 1, which resulted in 76.9% sensitivity and 88.6% specificity. The mean score of CPOT during suctioning was significantly different from that of before (t= -14.16, p<.001) or 20 minutes after suctioning (t=16.31, p<.001). Conclusion: Results of this study suggest that the CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal patients.

키워드

참고문헌

  1. Berne, R. M., & Levy, M. N. (1986). Cardiovascular physiology (5th ed.). St Louis, MO: CV Mosby Co.
  2. Bieri, D., Reeve, R, A., Champion, G. D., Addicoat, L., & Ziegler, J. B. (1990). The faces pain scale for the self-assessment of the severity of pain experienced by children: Development, initial validation, and preliminary investigation for ratio scale properties. Pain, 41, 139-150. http://dx.doi.org/10.1016/0304-3959(90)90018-9
  3. Cade, C. (2008). Clinical tools for the assessment of pain in sedated critically ill adults. Nursing in Critical Care, 13, 288-297. https://doi.org/10.1111/j.1478-5153.2008.00294.x
  4. Carrasco, G. (2000). Instruments for monitoring intensive care unit sedation. Critical Care, 4, 217-225. http://dx.doi.org/10.1186/cc697
  5. Chapman, D. W., & Carter, J. (1979). Translation procedures for the cross cultural use of measurement instruments. Educational Evaluation and Policy Analysis, 1(3), 71-76. http://dx.doi.org/10.3102/01623737001003071
  6. Feldt, K. S. (2000). The checklist of nonverbal pain indicators. Pain Management Nursing, 1(1), 13-21. http://dx.doi.org/10.1053/jpmn.2000.5831
  7. Fraser, G. L., & Riker, R. R. (2001). Monitoring sedation, agitation, analgesia, and delirium in critically ill adult patients. Critical Care Clinics, 17, 967-988. http://dx.doi.org/10.1016/S0749-0704(05)70189-5
  8. Gelinas, C., Fillion, L., Puntillo, K. A., Viens, C., & Fortier, M. (2006). Validation of the critical-care pain observation tool in adult patients. American Journal of Critical Care, 15, 420-427.
  9. Gelinas, C., Fillion, L., & Puntillo, K. A. (2008). Item selection and content validity of the critical-care pain observation tool for non-verbal adult. Journal of Advanced Nursing, 65, 203-216. http://dx.doi.org/10.1111/j.1365-2648.2008.04847.x
  10. Gelinas, C., Harel, F., Fillion, L., Puntillo, K. A., & Johnston, C. (2009). Sensitivity and specificity of the critical-care pain observation tool for the detection of pain in intubated adults after cardiac surgery. Journal of Pain and Symptom Management, 37(1), 58-67. https://doi.org/10.1016/j.jpainsymman.2007.12.022
  11. Gelinas, C., & Johnston, C. (2007). Pain assessment in the critically ill ventilated adult: Validation of the critical-care pain observation tool and physiologic indicators. The Clinical Journal of Pain, 23, 497-505. http://dx.doi.org/10.1097/AJP.0b013e31806a23fb
  12. Greiner, M., Pfeiffer, D., & Smith, R. D. (2000). Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Preventive Veterinary Medicine, 45, 23-41. http://dx.doi.org/10.1016/S0167-5877(00)00115-X
  13. Hamill, R. J., & Marohn, M. L. (1999). Evaluation of pain in the critically ill patient. Critical Care Clinics, 15, 35-54. http://dx.doi.org/10.1016/S0749-0704(05)70038-5
  14. Hwang, Y. H., & Choe, M. A. (2008). Study on the changes in limb circumferences and muscle areas of critically ill patients using ventilators. Journal of Korean Academy of Nursing, 38, 874-880. http://dx.doi.org/10.4040/jkan.2008.38.6.874
  15. Kim, Y. H., Koo, M. J., Kim, S. H., Kim, Y. M., Lee, N. Y., & Chang, K. O. (2007). The experiences of patients in intensive care units. Journal of Korean Academy of Nursing, 37, 924-931. https://doi.org/10.4040/jkan.2007.37.6.924
  16. Li, D., Puntillo, K., & Miaskowski, C. (2008). A review of objective pain measures for use with critical care adult patients unable to self-report. The Journal of Pain, 9(1), 2-10. http://dx.doi.org/10.1016/j.jpain.2007.08.009
  17. Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed.). New York, NY: McGraw-Hill.
  18. Nygaard, H. A., & Jarland, M. (2006). The checklist of nonverbal pain indictors(CNPI): Testing of reliability and validity in Norwegian nursing homes. Age and Ageing, 35(1), 79-81. http://dx.doi.org/10.1093/ageing/afj008
  19. Odhner, M., Wegman, D., Freeland, N., Steinmetz, A., & Ingersoll, G. (2003). Assessing pain control in nonverval critically ill adults. Dimensions of Critical Care Nursing, 22, 260-267. https://doi.org/10.1097/00003465-200311000-00010
  20. Payen, J. F., Bru, O., Bosson, J. L., Lagrasta, A., Novel, E., Deschaux, I., et al. (2001). Assessing pain in critically ill sedated patients by using a behavioral pain scale. Critical Care Medicine, 29, 2258-2263. https://doi.org/10.1097/00003246-200112000-00004
  21. Payen, J. F., Chanques, G., Mantz, J., Hercule, C., Auriant I, Leguillou, J. L., et al. (2007). Current practices in sedation and analgesia for mechanically ventilated critically ill patients: A prospective multicenter patientbased study. Anesthesiology, 106, 687-95. http://dx.doi.org/10.1097/01.anes.0000264747.09017.da
  22. Puntillo, K. A., Morris, A. B., Thomson, C. L., Stanik-Hutt, J., White, C. A., & Wild, L. R. (2004). Pain behaviors observed during six common procedure: Result from thunder project II. Critical Care Medicine, 32, 421-427. http://dx.doi.org/10.1097/01.CCM.0000108875.35298.D2
  23. Puntillo, K. A., Stannard, D., Miakowski, C., Kehrle, K., & Gleeson, S. (2002). Use of pain assessment and intervention notation(P.A.I.N) tool in critical care nursing practice: Nurses' evaluation. Heart & Lung, 31, 303-314. http://dx.doi.org/10.1067/mhl.2002.125652
  24. Sessler, C. N., & Varney, K. (2008). Patient-focused sedation and analgesia in the ICU. Chest, 133, 552-565. http://dx.doi.org/10.1378/chest. 07- 2026
  25. Shannon, K., & Bucknall, T. (2003). Pain assessment in critical care: What have we learnt from research. Intensive and Critical Care Nursing, 19, 154-162. https://doi.org/10.1016/S0964-3397(03)00027-2
  26. Siffleet, J., Young, J., Nikoletti, S., & Shaw, T. (2007). Patients' self-report of procedural pain in the intensive care unit. Journal of Clinical Nursing, 16, 2142-2148. http://dx.doi.org/10.1111/j.1365-2702.2006.01840.x
  27. Stanik-Hutt, J. A., Soeken, K. L., Belcher, A. E., Fontaine, D. K., & Gift, A. G. (2001). Pain experience of traumatically injured patients in a critical care setting. American Journal of Critical Care, 10, 252-259.
  28. Swets, J. A. (1988). Measuring the accuracy of diagnostic systems. Science, 240, 1285-1293. http://dx.doi.org/10.1126/science.3287615
  29. Teasdale, G., & Jennett, B. (1974). Assessment of coma and impaired consciousness. A practical scale. Lancet, 2, 81-84.
  30. Wang, H., & Tsai, Y. (2010). Nurse's knowledge and barriers regarding pain management in intensive care units. Journal of Clinical Nursing, 19, 3188-3196. http://dx.doi.org/10.1111/j.1365-2702.2010.03226.x

피인용 문헌

  1. 음악중재가 인공호흡기 유지 중환자의 통증에 미치는 효과 vol.15, pp.4, 2012, https://doi.org/10.7586/jkbns.2013.15.4.247
  2. 국내·외 중환자간호 연구의 동향 분석: 양적 연구를 중심으로 vol.27, pp.4, 2012, https://doi.org/10.7475/kjan.2015.27.4.384
  3. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU vol.46, pp.9, 2012, https://doi.org/10.1097/ccm.0000000000003299
  4. Validation of the Dutch version of the critical‐care pain observation tool vol.24, pp.3, 2012, https://doi.org/10.1111/nicc.12225
  5. The German version of the Critical-Care Pain Observation Tool for critically ill adults : A prospective validation study vol.68, pp.12, 2019, https://doi.org/10.1007/s00101-019-00694-5
  6. A Psychometric Analysis Update of Behavioral Pain Assessment Tools for Noncommunicative, Critically Ill Adults vol.30, pp.4, 2012, https://doi.org/10.4037/aacnacc2019952
  7. 중환자 통증 평가 도구에 관한 체계적 문헌고찰 vol.13, pp.1, 2012, https://doi.org/10.34250/jkccn.2020.13.1.44
  8. Translation into Spanish and Cultural Adaptation of the Critical-Care Pain Observation Tool vol.29, pp.3, 2012, https://doi.org/10.4037/ajcc2020763