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Med Intensiva. 2016 Nov;40(8):463-473. doi: 10.1016/j.medin.2016.06.004. Epub 2016 Aug 31.

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.

[Article in English, Spanish]

Author information

1
Medical Intensive Care Unit, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain. Electronic address: ntx_2002@yahoo.es.
2
Medical Intensive Care Unit, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain.
3
Nursing and Healthcare, Research Area, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain.
4
Emergency and Trauma Intensive Care Unit, Hospital Universitario Doce de Octubre, Madrid, Spain.
5
Intensive Care Unit, Hospital Universitario de Getafe, Getafe, Spain.
6
Intensive Care Unit, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Spain.
7
Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
8
Intensive Care Unit, Hospital Universitario de la Santa Creu i Sant Pau, Barcelona, Spain.
9
Intensive Care Unit, Hospital Universitario Doce de Octubre, Madrid, Spain.
10
Postsurgical Intensive Care Unit, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain.
11
Postsurgical Intensive Care Unit, Hospital Universitario de Basurto, Bilbao, Spain.
12
Intensive Care Unit, Hospital Universitario de La Princesa, Madrid, Spain.
13
Intensive Care Unit, Hospital Universitario de Cruces, Barakaldo, Spain.

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

PMID:
27590592
DOI:
10.1016/j.medin.2016.06.004
[Indexed for MEDLINE]
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