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Şişman H, Akpolat R, Alptekin D. Determination of Pain-Related Knowledge and Behaviors of Adult Intensive Care Nurses. Pain Manag Nurs 2024; 25:e250-e255. [PMID: 38458848 DOI: 10.1016/j.pmn.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 02/02/2024] [Accepted: 02/11/2024] [Indexed: 03/10/2024]
Abstract
AIM To determine the knowledge and attitudes of adult intensive care nurses regarding pain. METHOD This descriptive and cross-sectional study was conducted with 196 nurses working in the intensive care units of a tertiary university hospital between June 2022 and September 2022. Data were collected by face-to-face interview method, and the "Personal Information Form" and "Nurses' Knowledge and Attitude Scale Regarding Pain" were used as data collection tools. RESULTS About 71.8% of the nurses were between the ages of 18 and 30, 58.5% were women, 54.9% had a bachelor's degree, and 55.1% had been working in intensive care for 0-5 years. The nurses' total knowledge and attitude score levels were 11.8% inadequate, 64.1% moderate, and 24.1% good. A statistically significant relationship was found between age, gender, receiving training on pain in the institution, satisfaction level with the unit in which one works, frequency of pain assessment and indicators taken into consideration when evaluating pain severity, and the total scale score average (p < 0.05). CONCLUSIONS The average pain knowledge and attitude scores of intensive care nurses are at a good level. Results can be further improved with planned training on pain.
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Affiliation(s)
- Hamide Şişman
- Department of Abdi Sutcu Vocational School of Health Services, Cukurova University, Adana, Turkey.
| | - Refiye Akpolat
- Department of Nursing, Cyprus International University School of Health Sciences, Nicosia, Cyprus
| | - Dudu Alptekin
- Department of Abdi Sutcu Vocational School of Health Services, Cukurova University, Adana, Turkey
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Ghayem H, Heidari MR, Aghaei B, Norouzadeh R. The Effect of Training the Nonverbal Pain Scale (NVPS) on the Ability of Nurses to Monitor the Pain of Patients in the Intensive Care Unit. Indian J Crit Care Med 2023; 27:195-200. [PMID: 36960117 PMCID: PMC10028721 DOI: 10.5005/jp-journals-10071-24425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Pain in the intensive care unit is a silent fact. Considering the positive features of the nonverbal pain scale (NVPS) in assessing the pain of non-verbal patients, this study investigates the effect of training the NVPS on the ability of nurses to monitor the pain of patients in the intensive care unit. Materials and methods In this semi-experimental study, the effect of the NVPS training on the ability of 50 intensive care unit (ICU) nurses of Imam Khomeini Hospital affiliated to Ahvaz University of Medical Sciences was investigated. At first, the ability to diagnose the presence and intensity of pain was checked by a checklist. Then the nurses were taught how to use the scale correctly. After 2 weeks of training completion, the ability to correctly use the scale was measured again. Data analysis was performed using descriptive statistics (mean and standard deviation) and inferential statistics (McNemar, Chi-squared, paired t-test, and Fisher's exact test) in SPSS software version 16. Results After the training on the non-verbal pain scale, there was a significant difference between the intervention and control groups in diagnosing the presence of pain related to changing the patient's position (p = 0.023). Also, nurses ability to diagnose pain intensity during airway suction increased fourfold and for physiotherapy procedures twice as much as before training. Conclusion Nonverbal pain scale training improves ICU nurses ability in diagnosing the presence and severity of pain in nonverbal patients. How to cite this article Ghayem H, Heidari MR, Aghaei B, Norouzadeh R. The Effect of Training the Nonverbal Pain Scale (NVPS) on the Ability of Nurses to Monitor the Pain of Patients in the Intensive Care Unit. Indian J Crit Care Med 2023;27(3):195-200.
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Affiliation(s)
- Heydar Ghayem
- Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran
| | - Mohammad Reza Heidari
- Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran
| | - Bahman Aghaei
- Department of Medical-surgical Nursing, School of Nursing, Qom University of Medical Sciences, Qom, Iran
| | - Reza Norouzadeh
- Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran
- Reza Norouzadeh, Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran Phone: +98(21) 51212147, e-mail:
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Gélinas C, Joffe AM, Szumita PM, Payen JF, Bérubé M, Shahiri T S, Boitor M, Chanques G, Puntillo KA. A Psychometric Analysis Update of Behavioral Pain Assessment Tools for Noncommunicative, Critically Ill Adults. AACN Adv Crit Care 2020; 30:365-387. [PMID: 31951666 DOI: 10.4037/aacnacc2019952] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This is an updated, comprehensive review of the psychometric properties of behavioral pain assessment tools for use with noncommunicative, critically ill adults. Articles were searched in 5 health databases. A total of 106 articles were analyzed, including 54 recently published papers. Nine behavioral pain assessment tools developed for noncommunicative critically ill adults and 4 tools developed for other non-communicative populations were included. The scale development process, reliability, validity, feasibility, and clinical utility were analyzed using a 0 to 20 scoring system, and quality of evidence was also evaluated. The Behavioral Pain Scale, the Behavioral Pain Scale-Nonintubated, and the Critical-Care Pain Observation Tool remain the tools with the strongest psychometric properties, with validation testing having been conducted in multiple countries and various languages. Other tools may be good alternatives, but additional research on them is necessary.
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Affiliation(s)
- Céline Gélinas
- Céline Gélinas is Associate Professor, Ingram School of Nursing, McGill University, 680 Sherbrooke West, Room 1838, Montréal, Québec, Canada, H3A 2M7; and Researcher, Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montréal, Québec, Canada
| | - Aaron M Joffe
- Aaron M. Joffe is Professor, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington
| | - Paul M Szumita
- Paul M. Szumita is Clinical Pharmacy Practice Manager and Program Director - PGY2 Critical Care Pharmacy Practice Residency, Department of Pharmacy Services, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jean-Francois Payen
- Jean-Francois Payen is Professor, Department of Anesthesiology and Critical Care, and Researcher, Inserm, U1216, Grenoble Institut Neurosciences, Grenoble Alpes University Hospital, Grenoble, France
| | - Mélanie Bérubé
- Mélanie Bérubé is Assistant Professor, Faculty of Nursing, Université Laval; and Researcher, CHU de Québec, Université Laval Research Center (Hôpital de l'Enfant-Jésus), Québec City, Québec, Canada
| | - Shiva Shahiri T
- Shiva Shahiri T is a PhD Student, Ingram School of Nursing, McGill University
| | - Madalina Boitor
- Madalina Boitor is a Student, Faculty of Dentistry, McGill University
| | - Gerald Chanques
- Gerald Chanques is Professor, Department of Anesthesia & Critical Care Medicine, Montpellier University Hospital Saint Eloi, and PhyMedExp, University of Montpellier, INSERM, CNRS, 34295 Montpellier cedex 5, France
| | - Kathleen A Puntillo
- Kathleen A. Puntillo is Professor of Nursing Emeritus, University of California San Francisco School of Nursing, San Francisco, California
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Souza TLD, Azzolin KDO, Souza END. Validation of a multidisciplinary care protocol for critically ill patients with delirium. ACTA ACUST UNITED AC 2020; 41:e20190165. [PMID: 32491148 DOI: 10.1590/1983-1447.2020.20190165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 12/18/2019] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To validate a multiprofessional protocol for the care of patients with delirium admitted to an intensive care unit. METHOD Methodological study with the purpose of confirming with experts the care recommendations proposed in the protocol. For the content validation process, the content validity index of ≥ 0.90 was considered. RESULTS Of the 48 recommendations submitted to content validation, only four did not reach consensus through the content validity index. The multiprofessional protocol for patients with delirium in the intensive care unit included care related to the diagnosis of delirium, pause in sedation, early mobilization, pain management, agitation and delirium, cognitive guidance, sleep promotion, environmental interventions, and family participation. CONCLUSION The multiprofessional protocol qualifies the care provided to critically ill patients with delirium, improving clinical outcomes.
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Affiliation(s)
| | - Karina de Oliveira Azzolin
- Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
| | - Emiliane Nogueira de Souza
- Programa de Pós-Graduação em Enfermagem, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brasil
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Tao H, Galagarza SR. P-CPOT: An Adaptation of the Critical-Care Pain Observation Tool for Pediatric Intensive Care Unit Patients. Pain Manag Nurs 2019; 21:172-178. [PMID: 31506237 DOI: 10.1016/j.pmn.2019.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 07/08/2019] [Accepted: 07/23/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The Pediatric Critical-Care Observation Tool (P-CPOT) is an adaption of the Critical-Care Pain Observation Tool (CPOT) originally designed to assess pain in nonverbal critically-ill adults. AIM The study validated the P-CPOT in assessing nociceptive procedure pain in pediatric intensive care unit (PICU) children who are unable to verbalize pain. METHODS Content validity was tested using a two-round expert panel review with 8 experts. With a sample of 78 PICU patients, prospective repeated measures were designed to detect the change over time at pre- (T1), during (T2), and post- (T3) for routinely scheduled nociceptive procedures. Each measure was independently completed by two raters using two scales, the P-CPOT and the FLACC (Faces, Legs, Activity, Cry and Consolability). RESULTS All categories had Item-level content validity indices of 0.88 to 1.00. A one-factor structure containing 5 items was established and accounted for 85% variance in P-CPOT scores. Inter-rater reliability was substantial with correlation coefficient of 0.996 and Kappa value of 0.90. A threshold value of 4 resulted in excellent balance between sensitivity (98.6%) and specificity (97.6%). Both tools detected the score changes over time (p = .025). P-CPOT had a larger effect size (Cohen's d = 4.1) as well as a higher score than FLACC at T2 (p = .039). Linear regression revealed that patients being ventilated tended to have a P-CPOT score of 1.1 higher than the FLACC score while controlling for heart rates (p < .001), meaning that P-CPOT is more sensitive than FLACC for detecting pain increase during nociceptive procedures in ventilated patients. CONCLUSION The P-CPOT is a valid scale for assessing pain in PICU patients with very good psychometric performance. It is especially adept in detecting pain in ventilated patients.
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Affiliation(s)
- Hong Tao
- AdventHealth Whole-Person Research, Orlando, Florida.
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Frandsen JB, O'Reilly Poulsen KS, Laerkner E, Stroem T. Validation of the Danish version of the Critical Care Pain Observation Tool. Acta Anaesthesiol Scand 2016; 60:1314-22. [PMID: 27468726 DOI: 10.1111/aas.12770] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 07/02/2016] [Accepted: 07/05/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Assessing pain in critically ill patients is a challenge even in an intensive care unit (ICU) with a no sedation protocol. The aim of this study was to validate the Danish version of the pain assessment method; Critical Care Pain Observation Tool (CPOT) in an ICU with a no sedation protocol. METHODS Seventy patients were included in this study. The patients were observed during a non-nociceptive procedure (wash of an arm) and a nociceptive procedure (turning). Patients were observed before, during, and 15 min after the two interventions (six assessments). Two observers participated in the data collection and CPOT scores were blinded to each other. Calculations of interrater reliability, criterion validity and discriminant validity were performed to validate the Danish version of CPOT. RESULTS The results indicated a good correlation between the two raters (all scores > 0.9 and P < 0.05). About 48 (68.6%) of the included patients were able to self-report pain. We found a significantly higher mean CPOT score at the nociceptive procedure than at rest or the non-nociceptive procedure (P < 0.05). No correlation was found between CPOT scores and physiological indicators. Patients self-reported pain and CPOT showed a significant correlation (P < 0.05). A CPOT score of ≥ 3 correlated with patients' self-reported pain (ROC AUC 0.83). CONCLUSION The Danish version of CPOT can be used to assess pain in critically ill patients, also when the ICU has a no sedation protocol. CPOT scores showed a good interrater reliability and correlates well with patient's self-reported pain.
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Affiliation(s)
- J. B. Frandsen
- Department of Anaesthesia and Intensive Care Medicine; Odense University Hospital; Odense C Denmark
| | - K. S. O'Reilly Poulsen
- Department of Anaesthesia and Intensive Care Medicine; Odense University Hospital; Odense C Denmark
| | - E. Laerkner
- Department of Anaesthesia and Intensive Care Medicine; Odense University Hospital; Odense C Denmark
| | - T. Stroem
- Department of Anaesthesia and Intensive Care Medicine; Odense University Hospital; Odense C Denmark
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