The Korean Journal of Health Service Management (보건의료산업학회지)

Korea Society of Health Service Management (보건의료산업학회)
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Reliability and Validity of Nonverbal Pain Assessment Scale for Patients who Stayed a Intensive Care Units

무의식 중환자의 비언어적 통증사정 도구의 신뢰도와 타당도 검증

  • Kim, Jung-Soon (College of Nursing, Pusan National University) ;
  • Kang, In-Soon (College of Nursing, Pusan National University) ;
  • Park, Kyu-Hyun (Department of Neurologyl Pusan National University College of Medicine)
  • 김정순 (부산대학교 간호대학) ;
  • 강인순 (부산대학교 간호대학) ;
  • 박규현 (부산대학교 의학전문대학원 신경과학 교실)
  • Received : 2015.05.10
  • Accepted : 2015.06.24
  • Published : 2015.06.30
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Abstract

Patients unable to speak are at higher risk for untreated pain. Use of valid behavioral and physiologic measures for pain is highly recommended for uncommunicative patients. This study was performed to compare the reliability and validity of NVPS-K and CPOT-K for pain assessment of nonverbal patients. This study was conducted from July to November 2011. A total of 29 nonverbal adult patients admitted to a university hospital intensive care unit participated in this study. Interrater reliability of the NVPS-K and CPOT-K had intermediate to high intraclass correlation coefficients (NVPS-K 0.680 ~ 0.921, CPOT-K 0.710 ~ 0.896). Discriminant validity was supported with higher instrument scores during turning and endotracheal suctioning than that of NIBP. For criterion validity, the NVPS-K scores were correlated to the self-reported pain of the patients but not the CPOT-K scores. The areas under the ROC curve for the NVPS-K and CPOT-K were 0.748 and 0.696 with cutoff points of 1 and 2, respectively. Thus, the NVPS-K and CPOT-K had a sensitivity and specificity of 94.7% and 45.0%, and 60.5% and 75.0%, respectively. The NVPS-K and CPOT-K are reliable and valid tools to assess pain in nonverbal patient and thus, are recommended for the assessment of the pain in nonverbal patients.

Keywords

References

  1. S.J. Ahlers, L. Gulik, A.M. Veen, A.M., H.P.A. Dongen, P. Bruins, S.V. Belitser, A. Boer, D. Tibboel, C.A.J. Knibbe(2008), Comparison of different pain scoring systems in critically ill patients in a general ICU, Critical Care, Vol.12(1);R15. https://doi.org/10.1186/cc6789
  2. K.H. Hwang, E.N. Ryoo, K.S. Park(2007), A Study of the Nurses' Knowledge and Attitude about Pain Management, The Journal of Korean Academic Society of Nursing Education, Vol.13(1);41-51.
  3. C. Gelinas, M. Fortier, C. Viens, L. Fillion, K. Puntillo(2004), Pain assessment and management in critically ill intubated patients : A retrospective study, American Journal of Critical Care, Vol.13;126-136.
  4. M. Paulson-Conger, J. Leske, C. Maidl, A. Hanson, L. Dziadulewicz(2010), Comparison of two pain assessment tools in nonverbal critical care patients, Pain Management Nursing, Vol.12(4);218-224. https://doi.org/10.1016/j.pmn.2010.05.008
  5. E.N. Ryoo, K.S. Park(2011), Validity, Reliability and Efficiency of Pain Self-report Scale in Elderly with Dementia, Journal of Korean Academy of Adult Nursing, Vol.23(2);111-122.
  6. K.L. Kwekkeboom, K.A. Herr(2001), Assessment of pain in the critically ill, Critical Care Nursing Clinics of North American, Vol.13(2);181-194.
  7. J.F. Payen, O. Bru, J.L. Bosson, A. Lagrasta, E. Novel, I. Deschaux, P. Lavagne, C. Jacquot(2001), Assessing pain in critically ill sedated patients by using a behavioral pain scale, Critical Care Medicine, Vol.29;2258-2263. https://doi.org/10.1097/00003246-200112000-00004
  8. C. Gelinas, F. Harel, L. Fillion, K. Puntillo, C. Johnston(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, Vol.37(1);58-67. https://doi.org/10.1016/j.jpainsymman.2007.12.022
  9. M. Odhner, D. Wegman, N. Freeland, A. Steinmetz, G. Ingersoll(2003), Assessing pain control in nonverbal critically ill adults, Dimensions of Critical Care Nursing, Vol.22(6);260-267. https://doi.org/10.1097/00003465-200311000-00010
  10. O.M. Mateo, D.A. Krenzischek(1992), A pilot study to assess the relationship between behavioral manifestations and self-report of pain in postanaesthesia care unit patients, Journal of post anesthesia nursing, Vol.7;15-21.
  11. A. Blenkharn, S. Faughnan, A. Morgan(2002), Developing a pain assessment tool for use by nurses in an adult intensive care unit, Intensive and Critical Care Nursing, Vol.18;332-341. https://doi.org/10.1016/S0964-3397(02)00071-X
  12. C. Gelinas, L. Fillion, K.A. Puntillo, C. Viens, M. Fortier(2006), Validation of the critical-care pain observation tool in adult patients, American Journal of Critical Care, Vol.15;420-427.
  13. S. Pudas-Tahka, A. Axelin, R. Aantaa, V. Lund, S. Salantera(2009), Pain assessment tools for unconscious or sedated intensive care patients: a systematic review, Journal of Advanced Nursing, Vol.65(5);946-956. https://doi.org/10.1111/j.1365-2648.2008.04947.x
  14. M.J. Kim(2008), Reliability and Validity of a Behavioral Pain Scale for Unconscious Patients with Mechanical Ventilator in ICU, Unpublished master's thesis Keimyung University, pp.1-43.
  15. K.I. Kang(2009), Changing pattern of pain assessed by critical care pain observation tool and relating factors of pain for the brain injury patients in critical period, Unpublished master's thesis In-ha University, pp.1-74.
  16. E.M. Kwak(2012), Validation of a Korean Translated Version of the Critical Care Pain Observation Tool(CPOT) for ICU Patients, Unpublished master's thesis Eulji University, pp.1-55.
  17. L. Marmo, S. Fowler(2010), Pain assessment tool in the critically ill post-open heart surgery patient population, American Society for Pain Management Nursing, Vol.11(3);134-140. https://doi.org/10.1016/j.pmn.2009.05.007
  18. A. Kabes, J. Graves, J. Norris(2009), Further Validation of the nonverbal pain scale in intensive care patients, American Journal of Critical Care, Vol.29(1);59-66.
  19. P. Juarez, M. Baker, D. Duey, S. Durkin(2010), Comparison of two pain scales for the assessment of pain in the ventilated adult patient, Dimensions of Critical Care Nursing, Vol.29(6);307-315. https://doi.org/10.1097/DCC.0b013e3181f0c48f
  20. K. Puntillo, B. Morris, L. Thomson, J. Stanik-Hutt, A. White, R. Wild(2004), Pain behaviors observed during six common procedure : Result from Thunder ProjectII, Critical Care Medicine, Vol.32(2);421-427. https://doi.org/10.1097/01.CCM.0000108875.35298.D2
  21. J. Siffleet, J. Young, S. Nikoletti, T. Shaw(2007), Patients' self-report of procedural pain in the intensive care unit, Journal of Clinical Nursing, Vol.16;2142-2418. https://doi.org/10.1111/j.1365-2702.2006.01840.x
  22. K.S. Lee, W.H. Lee, M.H. Yun(2012), Relationship between musculoskeletal pain and job satisfaction of the physical therapists in elderly care facilities, The Korean Journal of Health Service Management, Vol.6(4);49-60. https://doi.org/10.12811/kshsm.2012.6.4.049
  23. C. Gelinas, C. Johnston(2007), Pain assessment in the critically ill ventilated adult: validation of the critical-care pain pbservation tool and Physiologic Indicators, Clinical Journal of Pain, Vol.23(6);497-505. https://doi.org/10.1097/AJP.0b013e31806a23fb
  24. S.W. Song(2009), Using the Receiver Operating Characteristic (ROC) Curve to Measure Sensitivity and Specificity, Korean Journal of Family Medicine, Vol.30(11);841-842. https://doi.org/10.4082/kjfm.2009.30.11.841
  25. Y. Tousignant-Laflamme, P. Bourgault, C. Gelinas, S. Marchand(2010), Assessing pain behaviors in healthy subjects using the critical-care pain observation tool (CPOT): A pilot study, The Journal of Pain, Vol.11(6);983-987. https://doi.org/10.1016/j.jpain.2010.01.266

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