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VOLUME 21 , ISSUE 7 ( 2017 ) > List of Articles

RESEARCH ARTICLE

A Study on The Psychometric Properties of Revised-Nonverbal Pain Scale and Original-Nonverbal Pain Scale in Iranian Nonverbal-Ventilated Patients

Hoda Chookalayi, Mohammad Hasanpour, Sajjad Jabrailzadeh, Fatemeh Sadeghpour

Keywords : Instrument, Intensive Care Unit, mechanical ventilation, pain, pain measurement

Citation Information : Chookalayi H, Hasanpour M, Jabrailzadeh S, Sadeghpour F. A Study on The Psychometric Properties of Revised-Nonverbal Pain Scale and Original-Nonverbal Pain Scale in Iranian Nonverbal-Ventilated Patients. Indian J Crit Care Med 2017; 21 (7):429-435.

DOI: 10.4103/ijccm.IJCCM_114_17

License: CC BY-ND 3.0

Published Online: 01-07-2018

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Background and Aims: The nonverbal pain scale is one of the instruments which study pain in nonverbal-ventilated patients with regard to the changes of behavioral and physiological indices. The purpose of the study is to survey the psychometric properties of revised-nonverbal pain scale (R-NVPS) and original-nonverbal pain scale (O-NVPS) in ventilated patients hospitalized in critical care units. Materials and Methods: Four nurses studied pain in sixty patients hospitalized in trauma, medical, neurology, and surgical critical care units using R-NVPS and O-NVPS at six times (before, during, and after nociceptive and nonnociceptive procedures). The test was repeated in 37 patients after 8–12 h. Results: Cronbach's alpha coefficient for R-NVPS and O-NVPS was 0.8 and 0.76, respectively. The inter-rater correlation coefficient during different times was r = 0.89–0.96 for R-NVPS and r = 0.80–0.87 for O-NVPS. Test-retest correlation coefficient for R-NVPS and O-NVPS was r = 0.55–0.86 and r = 0.51–0.75, respectively. The meaningful difference in pain score between nociceptive and nonnociceptive procedures (P < 0.001) and a higher pain score in patients who confirmed pain (P < 0.001) showed a discriminant and criterion validity for both scales of NVPS, respectively. Conclusions: R-NVPS and O-NVPS can both be used as valid and reliable scales in studying pain in ventilated patient. However, in comparing the items, “respiration” (R-NVPS) had a higher sensitivity than “physiology II” (O-NVPS) in assessing pain.


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  1. Young J, Siffleet J, Nikoletti S, Shaw T. Use of a Behavioural Pain Scale to assess pain in ventilated, unconscious and/or sedated patients. Intensive Crit Care Nurs 2006;22:32-9.
  2. Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care 2006;15:420-7.
  3. Arbour C, Gélinas C, Michaud C. Impact of the implementation of the Critical-Care Pain Observation Tool (CPOT) on pain management and clinical outcomes in mechanically ventilated trauma Intensive Care Unit patients: A pilot study. J Trauma Nurs 2011;18:52-60.
  4. Chanques G, Viel E, Constantin JM, Jung B, de Lattre S, Carr J, et al. The measurement of pain in Intensive Care Unit: Comparison of 5 self-report intensity scales. Pain 2010;151:711-21.
  5. Rijkenberg S, Stilma W, Endeman H, Bosman RJ, Oudemans-van Straaten HM. Pain measurement in mechanically ventilated critically ill patients: Behavioral Pain Scale versus Critical-Care Pain Observation Tool. J Crit Care 2015;30:167-72.
  6. Herr K, Coyne PJ, Key T, Manworren R, McCaffery M, Merkel S, et al. Pain assessment in the nonverbal patient: Position statement with clinical practice recommendations. Pain Manag Nurs 2006;7:44-52.
  7. Merkel S, Voepel-Lewis T, Malviya S. Pain assessment in infants and young children: The FLACC scale. Am J Nurs 2002;102:55-8.
  8. Pasero C, McCaffery M. Pain in the critically ill: New information reveals that one of the simplest procedures-turning-can be the most painful one. Am J Nurs 2002;102:59-60.
  9. Payen JF, Bru O, Bosson JL, Lagrasta A, Novel E, Deschaux I, et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med 2001;29:2258-63.
  10. Gélinas C, Johnston C. Pain assessment in the critically ill ventilated adult: Validation of the Critical-Care Pain Observation Tool and physiologic indicators. Clin J Pain 2007;23:497-505.
  11. Liu Y, Li L, Herr K. Evaluation of two observational pain assessment tools in Chinese critically ill patients. Pain Med 2015;16:1622-8.
  12. Kwekkeboom KL, Herr K. Assessment of pain in the critically ill. Crit Care Nurs Clin North Am 2001;13:181-94.
  13. Foster RL, Yucha CB, Zuk J, Vojir CP. Physiologic correlates of comfort in healthy children. Pain Manag Nurs 2003;4:23-30.
  14. Odhner M, Wegman D, Freeland N, Steinmetz A, Ingersoll GL. Assessing pain control in nonverbal critically ill adults. Dimens Crit Care Nurs 2003;22:260-7.
  15. Topolovec-Vranic J, Gelinas C, Li Y, Pollmann-Mudryj MA, Innis J, McFarlan A, et al. Validation and evaluation of two observational pain assessment tools in a trauma and neurosurgical Intensive Care Unit. Pain Res Manag 2013;18:e107-14.
  16. Kabes AM, Graves JK, Norris J. Further validation of the nonverbal pain scale in intensive care patients. Crit Care Nurse 2009;29:59-66.
  17. Wegman DA. Tool for pain assessment. Crit Care Nurse 2005;25:14-5.
  18. Chanques G, Pohlman A, Kress JP, Molinari N, de Jong A, Jaber S, et al. Psychometric comparison of three behavioural scales for the assessment of pain in critically ill patients unable to self-report. Crit Care 2014;18:R160.
  19. Juarez P, Bach A, Baker M, Duey D, Durkin S, Gulczynski B, et al. Comparison of two pain scales for the assessment of pain in the ventilated adult patient. Dimens Crit Care Nurs 2010;29:307-15.
  20. Arbour C, Gélinas C. Are vital signs valid indicators for the assessment of pain in postoperative cardiac surgery ICU adults? Intensive Crit Care Nurs 2010;26:83-90.
  21. Arbour C, Choinière M, Topolovec-Vranic J, Loiselle CG, Gélinas C. Can fluctuations in vital signs be used for pain assessment in critically ill patients with a traumatic brain injury? Pain Res Treat 2014;2014:175794.
  22. Azevedo-Santos IF, Alves IG, Badauó-Passos D, Santana-Filho VJ, DeSantana JM. Psychometric analysis of behavioral pain scale Brazilian version in sedated and mechanically ventilated adult patients: A preliminary study. Pain Pract 2016;16:451-8.
  23. LoBiondo-Wood G, Haber J, Berry C, Yost J. Study Guide for Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice. U.S.A.: Elsevier Health Sciences; 2013.
  24. Chen YY, Lai YH, Shun SC, Chi NH, Tsai PS, Liao YM. The Chinese Behavior Pain Scale for critically ill patients: Translation and psychometric testing. Int J Nurs Stud 2011;48:438-48.
  25. Li Q, Wan X, Gu C, Yu Y, Huang W, Li S, et al. Pain assessment using the Critical-Care Pain Observation Tool in Chinese critically ill ventilated adults. J Pain Symptom Manage 2014;48:975-82.
  26. Marmo L, Fowler S. Pain assessment tool in the critically ill post-open heart surgery patient population. Pain Manag Nurs 2010;11:134-40.
  27. Görges M, Markewitz BA, Westenskow DR. Improving alarm performance in the medical Intensive Care Unit using delays and clinical context. Anesth Analg 2009;108:1546-52.
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