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
I Latorre-Marco, M Acevedo-Nuevo, M Solís-Muñoz, L Hernández-Sánchez, C López-López, M M Sánchez-Sánchez, M Wojtysiak-Wojcicka, J de Las Pozas-Abril, G Robleda-Font, M J Frade-Mera, R De Blas-García, C Górgolas-Ortiz, J De la Figuera-Bayón, C Cavia-García, I Latorre-Marco, M Acevedo-Nuevo, M Solís-Muñoz, L Hernández-Sánchez, C López-López, M M Sánchez-Sánchez, M Wojtysiak-Wojcicka, J de Las Pozas-Abril, G Robleda-Font, M J Frade-Mera, R De Blas-García, C Górgolas-Ortiz, J De la Figuera-Bayón, C Cavia-García
Abstract
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-α 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-α value of 0.85 (95%CI 0.81-0.88). Cronbach-α 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. CLINICALTRIALS.GOV: NCT01744717.
Keywords: Behavior; Conductual; Critically ill patients; Dolor; Escala; Fiabilidad; Mechanical ventilation; Paciente crítico; Pain assessment; Reliability; Scale; Validez; Validity; Ventilación mecánica.
Copyright © 2016 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.
Source: PubMed