Turkish Validity and Reliability of the Behavioral Indicators of Pain Scale(ESCID)

March 13, 2026 updated by: Mehmet Burak UYAROĞLU, Saglik Bilimleri Universitesi

Reliability and Validity of the Turkish Version of the Behavioral Indicators of Pain Scale in Mechanically Ventilated Intensive Care Unit Patients

A significant proportion of patients hospitalized in intensive care units (ICUs) require mechanical ventilation, and the treatments applied during this process may cause pain. Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Although it is associated with delirium and agitation, pain is often an overlooked symptom in ICU patients, and a large proportion of mechanically ventilated patients continue to experience moderate to severe pain. The most common type of pain in critically ill patients is nociceptive pain, which may result from invasive procedures such as tracheal intubation, catheter insertion, aspiration, wound care, and patient repositioning. Additionally, the noisy and unfamiliar ICU environment and patients' inability to express themselves may further increase the perception of pain.

Regular assessment of pain is associated with many positive outcomes, including more effective pain management, appropriate use of analgesic and sedative medications, and shorter duration of mechanical ventilation and ICU stay. Although self-reporting of pain is considered the gold standard, many patients receiving mechanical ventilation are unable to communicate their pain. Therefore, various behavioral pain assessment scales are used to evaluate pain in ICU patients. One of these tools is the Behavioral Indicators of Pain Scale (Escala de Conductas Indicadoras de Dolor - ESCID), which was developed to assess pain in critically ill adult patients receiving mechanical ventilation who are unable to communicate. However, a Turkish version of this scale has not yet been developed. Therefore, the aim of this study is to translate the ESCID scale into Turkish, perform its cultural adaptation, and test the validity and reliability of the Turkish version.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

50

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Individuals aged 18 years and older
  • Patients who are intubated, receiving mechanical ventilation, and unable to establish verbal communication (Glasgow Coma Scale score <14)
  • Patients who have been hospitalized in the intensive care unit for at least 24 hours

Exclusion Criteria:

  • Presence of postoperative complications
  • Hemodynamic instability
  • History of diagnosed cognitive or psychiatric disorders
  • History of epilepsy or use of neuromuscular blocking agents
  • History of spinal cord injury affecting motor function of all four extremities
  • Individuals with a Richmond Agitation-Sedation Scale (RASS) score of -5 (unresponsive)
  • Cases with suspected brain death

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Single Group
The ESCID scale will be applied to a sample of 50 patients.
Other: The ESCID scale

ESCID scale will be applied to 50 intubated ICU patients to assess pain through behavioral indicators.

The study evaluate the Turkish validity and reliability of the ESCID scale.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The Behavioral Indicators of Pain Scale (ESCID)
Time Frame: 5 month
ESCID evaluates pain based on observable behavioral indicators, including facial expression, calmness, muscle tone, comfort level, and adaptation to mechanical ventilation. Each item is scored from 0 to 2, and the total score reflects the patient's level of pain. The application of ESCID allows systematic and objective pain assessment in patients who cannot self-report their pain.
5 month

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Saglik Bilimleri Universitesi

Collaborators

Goztepe Prof Dr Suleyman Yalcın City Hospital
Fenerbahce University

Investigators

  • Principal Investigator: Mehmet Burak Uyaroğlu, Asst Prof, Fenerbahçe University
  • Study Director: Esra Pehlivan, Prof Dr, Saglik Bilimleri University
  • Study Chair: Hasan Kocoglu, Prof Dr, Medeniyet University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2026

Primary Completion (Actual)

March 1, 2026

Study Completion (Estimated)

July 1, 2027

Study Registration Dates

First Submitted

March 9, 2026

First Submitted That Met QC Criteria

March 9, 2026

First Posted (Actual)

March 12, 2026

Study Record Updates

Last Update Posted (Actual)

March 16, 2026

Last Update Submitted That Met QC Criteria

March 13, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Fenerbahce

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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