Madalina Boitor1, Jacinthe Lachance Fiola, Céline Gélinas. 1. Madalina Boitor, RN, BSc(N) PhD Student, Ingram School of Nursing, McGill University, Montréal, Québec, Canada. Jacinthe Lachance Fiola, PhD Psychologist, Université du Québec à Montréal, Québec, Canada. Céline Gélinas, PhD, RN Associate Professor, Ingram School of Nursing, McGill University; Researcher and Project Director, Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital; Co-Leader of the Research Axis on Personalized Care, Quebec Nursing Interventions Research Network (RRISIQ); and Member of Alan Edwards Centre for Research on Pain, McGill University, Montréal, Québec, Canada.
Abstract
BACKGROUND: The Critical-Care Pain Observation Tool (CPOT) is a behavioral scale recommended in clinical practice guidelines for the assessment of pain in nonverbal intensive care unit (ICU) adults. Although the CPOT has been validated in various ICU patient groups, its association with the affective component of pain has not yet been explored, and in most studies, turning was the used nociceptive procedure. AIM: In this study, we aim to validate the use of the CPOT and vital signs in association with the sensory and affective components of pain during mediastinal tube removal (MTR) in postoperative cardiac surgery ICU adults. METHODS: A sample of 125 patients participated in this prospective repeated-measures, within-subject study. A total of 6 assessments of the main study variables (CPOT scores and patients' self-reports of pain intensity and unpleasantness) were completed by trained research assistants while patients were in the ICU. Assessments were done before, during, and 15 minutes after the nonnociceptive procedure (ie, noninvasive blood pressure taking [NIBP]) and nociceptive procedure (ie, MTR). RESULTS: Discriminant validation of the scale use was supported as higher CPOT scores were obtained during MTR (mean [SD], 2.74 [1.61]) compared with NIBP (mean [SD], 0.50 [0.747]) (t124 = 14.33, P < .001). Similarly, higher values were recorded for mean arterial pressure and heart and respiratory rates during MTR compared with NIBP (P < .01). During MTR, CPOT scores correlated significantly with self-report of pain intensity (r = 0.419, P < .01) and unpleasantness (r = 0.313, P < .01), supporting criterion and convergent validation. Conversely, vital signs did not correlate with either self-report. CONCLUSIONS: Study findings confirmed the validity of the CPOT for the assessment of the sensory and affective components of pain in the postcardiac surgery ICU adults. Vital signs were not specific to pain and should be used only as cues to begin further assessment of pain using validated instruments for this purpose.
BACKGROUND: The Critical-Care Pain Observation Tool (CPOT) is a behavioral scale recommended in clinical practice guidelines for the assessment of pain in nonverbal intensive care unit (ICU) adults. Although the CPOT has been validated in various ICU patient groups, its association with the affective component of pain has not yet been explored, and in most studies, turning was the used nociceptive procedure. AIM: In this study, we aim to validate the use of the CPOT and vital signs in association with the sensory and affective components of pain during mediastinal tube removal (MTR) in postoperative cardiac surgery ICU adults. METHODS: A sample of 125 patients participated in this prospective repeated-measures, within-subject study. A total of 6 assessments of the main study variables (CPOT scores and patients' self-reports of pain intensity and unpleasantness) were completed by trained research assistants while patients were in the ICU. Assessments were done before, during, and 15 minutes after the nonnociceptive procedure (ie, noninvasive blood pressure taking [NIBP]) and nociceptive procedure (ie, MTR). RESULTS: Discriminant validation of the scale use was supported as higher CPOT scores were obtained during MTR (mean [SD], 2.74 [1.61]) compared with NIBP (mean [SD], 0.50 [0.747]) (t124 = 14.33, P < .001). Similarly, higher values were recorded for mean arterial pressure and heart and respiratory rates during MTR compared with NIBP (P < .01). During MTR, CPOT scores correlated significantly with self-report of pain intensity (r = 0.419, P < .01) and unpleasantness (r = 0.313, P < .01), supporting criterion and convergent validation. Conversely, vital signs did not correlate with either self-report. CONCLUSIONS: Study findings confirmed the validity of the CPOT for the assessment of the sensory and affective components of pain in the postcardiac surgery ICU adults. Vital signs were not specific to pain and should be used only as cues to begin further assessment of pain using validated instruments for this purpose.
Authors: Céline Gélinas; Mélanie Bérubé; Kathleen A Puntillo; Madalina Boitor; Melissa Richard-Lalonde; Francis Bernard; Virginie Williams; Aaron M Joffe; Craig Steiner; Rebekah Marsh; Louise Rose; Craig M Dale; Darina M Tsoller; Manon Choinière; David L Streiner Journal: Crit Care Date: 2021-04-13 Impact factor: 9.097
Authors: Caíque Jordan Nunes Ribeiro; Andra Carla Santos de Araújo; Saulo Barreto Brito; Daniele Vieira Dantas; Mariangela da Silva Nunes; José Antonio Barreto Alves; Maria do Carmo de Oliveira Ribeiro Journal: Rev Bras Ter Intensiva Date: 2018-03
Authors: Katarzyna Kotfis; Małgorzata Zegan-Barańska; Marta Strzelbicka; Krzysztof Safranow; Maciej Żukowski; E Wesley Ely Journal: Arch Med Sci Date: 2017-09-01 Impact factor: 3.318