Debra L Wiegand1, Tracey Wilson2, Diane Pannullo3, Marguerite M Russo4, Karen Snow Kaiser5, Karen Soeken6, Deborah B McGuire7. 1. University of Maryland School of Nursing, Baltimore, Maryland. Electronic address: wiegand@son.umayland. 2. Medical Intensive Care Unit, University of Maryland Medical Center, Baltimore, Maryland. 3. Surgical Intensive Care Unit, University of Maryland Medical Center, Baltimore, Maryland. 4. Palliative Care, University of Maryland Medical Center, Baltimore, Maryland; University of Maryland Baltimore Graduate School, Baltimore, Maryland. 5. University of Maryland Medical System, Baltimore, Maryland. 6. University of Maryland School of Nursing, Baltimore, Maryland. 7. Virginia Commonwealth University School of Nursing, Richmond, Virginia.
Abstract
BACKGROUND: A valid and reliable instrument is needed to assess acute pain in critically ill patients unable to self-report and who may be transitioning between critical care and other settings. AIM: To examine the reliability, validity, and clinical utility of the Multidimensional Objective Pain Assessment Tool (MOPAT) when used over time by critical care nurses to assess acute pain in non-communicative critically ill patients. METHODS: Twenty-seven patients had pain assessed at two time points (T1 and T2) surrounding a painful event for up to 3 days. Twenty-one ICU nurses participated in pain assessments and completed the Clinical Utility Questionnaire. RESULTS: Internal consistency reliability coefficient alphas for the MOPAT were .68 at T1 and .72 at T2. Inter-rater agreement during painful procedures or turning was 68% for the behavioral dimension and 80% for the physiologic dimension. Validity was evidenced by decreases (p < .001) in the MOPAT total and behavioral and physiologic dimension scores when comparing T1 and T2. Nurses found the tool clinically useful. CONCLUSION: The MOPAT can be used in the critical care setting as a helpful tool to assess pain in non-communicative patients. The MOPAT is unique in that the instrument can be used over time and across settings.
BACKGROUND: A valid and reliable instrument is needed to assess acute pain in critically illpatients unable to self-report and who may be transitioning between critical care and other settings. AIM: To examine the reliability, validity, and clinical utility of the Multidimensional Objective Pain Assessment Tool (MOPAT) when used over time by critical care nurses to assess acute pain in non-communicative critically illpatients. METHODS: Twenty-seven patients had pain assessed at two time points (T1 and T2) surrounding a painful event for up to 3 days. Twenty-one ICU nurses participated in pain assessments and completed the Clinical Utility Questionnaire. RESULTS: Internal consistency reliability coefficient alphas for the MOPAT were .68 at T1 and .72 at T2. Inter-rater agreement during painful procedures or turning was 68% for the behavioral dimension and 80% for the physiologic dimension. Validity was evidenced by decreases (p < .001) in the MOPAT total and behavioral and physiologic dimension scores when comparing T1 and T2. Nurses found the tool clinically useful. CONCLUSION: The MOPAT can be used in the critical care setting as a helpful tool to assess pain in non-communicative patients. The MOPAT is unique in that the instrument can be used over time and across settings.
Authors: Matthew N Jaffa; Jamie E Podell; Madeleine C Smith; Arshom Foroutan; Adam Kardon; Wan-Tsu W Chang; Melissa Motta; Gunjan Y Parikh; Kevin N Sheth; Neeraj Badjatia; Michael J Armahizer; J Marc Simard; Nicholas A Morris Journal: Neurology Date: 2021-03-25 Impact factor: 9.910