Eun-Mi Kwak; Heeyoung Oh

doi:10.4040/jkan.2012.42.1.76

Articles

Page Path: HOME > J Korean Acad Nurs > Volume 42(1); 2012 > Article

Original Article
Validation of a Korean Translated Version of the Critical Care Pain Observation Tool (CPOT) for ICU Patients: Eun-Mi Kwak, Heeyoung Oh; Journal of Korean Academy of Nursing 2012;42(1):76-84.
DOI: https://doi.org/10.4040/jkan.2012.42.1.76
Published online: February 29, 2012

¹Nurse, Eulji University Hospital, Deajeon, Korea.

²Professor, College of Nursing, Eulji University, Deajeon, Korea.

Address reprint requests to: Oh, Heeyoung. College of Nursing, Eulji University, 143-5 Yongdu-dong, Jung-gu, Daejeon 301-832, Korea. Tel: +82-42-259-1713, Fax: +82-42-259-1709, hoh123@eulji.ac.kr

• Received: April 13, 2011 • Accepted: February 5, 2012

11 Views
0 Download

prev next

Full Article

Download PDF

Abstract
NOTES
REFERENCES

Abstract

Purpose
The purpose of this methodological study was to examine the reliability and validity of a translated Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients.
Methods
A cross-sectional study design was used. Data were collected from a convenience sample of 202 critically ill patients admitted to a university hospital. Upon establishment of content and translation equivalence between the English and Korean version of CPOT, psychometric properties were evaluated.
Results
The interrater reliability was found to be acceptable with the weighted kappa coefficients of .81-.88. Significant high correlations between the CPOT and the Checklist of Nonverbal Pain Indicators were found indicating good concurrent validity (r=.72-.83, p<.001). Data showed the area under the ROC curve of 0.86 with a cut-off point of 1, which resulted in 76.9% sensitivity and 88.6% specificity. The mean score of CPOT during suctioning was significantly different from that of before (t=-14.16, p<.001) or 20 minutes after suctioning (t=16.31, p<.001).
Conclusion
Results of this study suggest that the CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal patients.
Keywords: Pain; Pain measurement; Psychometrics; Critical care

This article is based on a part of the first author's master's thesis from the Eulji University.

REFERENCES

1. Berne R.M., Levy M.N. Cardiovascular physiology. 1986;5th ed. St Louis, MO, CV Mosby Co.
2. Bieri D., Reeve R.A., Champion G.D., Addicoat L., Ziegler J.B. The faces pain scale for the self-assessment of the severity of pain experienced by children: Development, initial validation, and preliminary investigation for ratio scale properties. Pain. 1990;41:139–150. http://dx.doi.org/10.1016/0304-3959(90)90018-9.Article PubMed
3. Cade C. Clinical tools for the assessment of pain in sedated critically ill adults. Nursing in Critical Care. 2008;13:288–297.Article PubMed
4. Carrasco G. Instruments for monitoring intensive care unit sedation. Critical Care. 2000;4:217–225. http://dx.doi.org/10.1186/cc697.PubMed PMC
5. Chapman D.W., Carter J. Translation procedures for the cross cultural use of measurement instruments. Educational Evaluation and Policy Analysis. 1979;1(3):71–76. http://dx.doi.org/10.3102/01623737001003071.Article PDF
6. Feldt K.S. The checklist of nonverbal pain indicators. Pain Management Nursing. 2000;1(1):13–21. http://dx.doi.org/10.1053/jpmn.2000.5831.Article PubMed
7. Fraser G.L., Riker R.R. Monitoring sedation, agitation, analgesia, and delirium in critically ill adult patients. Critical Care Clinics. 2001;17:967–988. http://dx.doi.org/10.1016/S0749-0704(05)70189-5.Article PubMed
8. Gélinas C., Fillion L., Puntillo K.A., Viens C., Fortier M. Validation of the critical-care pain observation tool in adult patients. American Journal of Critical Care. 2006;15:420–427.Article PubMed PDF
9. Gélinas C., Fillion L., Puntillo K.A. Item selection and content validity of the critical-care pain observation tool for non-verbal adult. Journal of Advanced Nursing. 2009;65:203–216. http://dx.doi.org/10.1111/j.1365-2648.2008.04847.x.Article PubMed
10. Gélinas C., Harel F., Fillion L., Puntillo K.A., Johnston C. Sensitivity and specificity of the critical-care pain observation tool for the detection of pain in intubated adults after cardiac surgery. Journal of Pain and Symptom Management. 2009;37(1):58–67.Article PubMed
11. Gélinas C., Johnston C. Pain assessment in the critically ill ventilated adult: Validation of the critical-care pain observation tool and physiologic indicators. The Clinical Journal of Pain. 2007;23:497–505. http://dx.doi.org/10.1097/AJP.0b013e31806a23fb.Article PubMed
12. Greiner M., Pfeiffer D., Smith R.D. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Preventive Veterinary Medicine. 2000;45:23–41. http://dx.doi.org/10.1016/S0167-5877(00)00115-X.Article PubMed
13. Hamill-Ruth R.J., Marohn M.L. Evaluation of pain in the critically ill patient. Critical Care Clinics. 1999;15:35–54. http://dx.doi.org/10.1016/S0749-0704(05)70038-5.Article PubMed
14. Hwang Y.H., Choe M.A. Study on the changes in limb circumferences and muscle areas of critically ill patients using ventilators. Journal of Korean Academy of Nursing. 2008;38:874–880. http://dx.doi.org/10.4040/jkan.2008.38.6.874.Article PubMed
15. Kim Y.H., Koo M.J., Kim S.H., Kim Y.M., Lee N.Y., Chang K.O. The experiences of patients in intensive care units. Journal of Korean Academy of Nursing. 2007;37:924–931.PubMed
16. Li D., Puntillo K., Miaskowski C. A review of objective pain measures for use with critical care adult patients unable to self-report. The Journal of Pain. 2008;9(1):2–10. http://dx.doi.org/10.1016/j.jpain.2007.08.009.Article PubMed
17. Nunnally J.C., Bernstein I.H.. Psychometric theory. 1994;3rd ed. New York, NY, McGraw-Hill.
18. Nygaard H.A., Jarland M. The checklist of nonverbal pain indictors(CNPI): Testing of reliability and validity in Norwegian nursing homes. Age and Ageing. 2006;35(1):79–81. http://dx.doi.org/10.1093/ageing/afj008.PubMed
19. Odhner M., Wegman D., Freeland N., Steinmetz A., Ingersoll G. Assessing pain control in nonverval critically ill adults. Dimensions of Critical Care Nursing. 2003;22:260–267.Article PubMed
20. Payen J.F., Bru O., Bosson J.L., Lagrasta A., Novel E., Deschaux I, et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Critical Care Medicine. 2001;29:2258–2263.Article PubMed
21. Payen J.F., Chanques G., Mantz J., Hercule C., Auriant I., Leguillou J.L, et al. Current practices in sedation and analgesia for mechanically ventilated critically ill patients: A prospective multicenter patient-based study. Anesthesiology. 2007;106:687–695. http://dx.doi.org/10.1097/01.anes.0000264747.09017.da.PubMed
22. Puntillo K.A., Morris A.B., Thomson C.L., Stanik-Hutt J., White C.A., Wild L.R. Pain behaviors observed during six common procedure: Result from thunder project II. Critical Care Medicine. 2004;32:421–427. http://dx.doi.org/10.1097/01.CCM.0000108875.35298.D2.Article PubMed
23. Puntillo K.A., Stannard D., Miakowski C., Kehrle K., Gleeson S. Use of pain assessment and intervention notation(P.A.I.N) tool in critical care nursing practice: Nurses evaluation. Heart & Lung. 2002;31:303–314. http://dx.doi.org/10.1067/mhl.2002.125652.Article
24. Sessler C.N., Varney K. Patient-focused sedation and analgesia in the ICU. Chest. 2008;133:552–565. http://dx.doi.org/10.1378/chest.07-2026.Article PubMed
25. Shannon K., Bucknall T. Pain assessment in critical care: What have we learnt from research. Intensive and Critical Care Nursing. 2003;19:154–162.PubMed
26. Siffleet J., Young J., Nikoletti S., Shaw T. Patients' self-report of procedural pain in the intensive care unit. Journal of Clinical Nursing. 2007;16:2142–2148. http://dx.doi.org/10.1111/j.1365-2702.2006.01840.x.Article PubMed
27. Stanik-Hutt J.A., Soeken K.L., Belcher A.E., Fontaine D.K., Gift A.G. Pain experience of traumatically injured patients in a critical care setting. American Journal of Critical Care. 2001;10:252–259.PubMed
28. Swets J.A. Measuring the accuracy of diagnostic systems. Science. 1988;240:1285–1293. http://dx.doi.org/10.1126/science.3287615.Article PubMed
29. Teasdale G., Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2:81–84.PubMed
30. Wang H., Tsai Y. Nurse's knowledge and barriers regarding pain management in intensive care units. Journal of Clinical Nursing. 2010;19:3188–3196. http://dx.doi.org/10.1111/j.1365-2702.2010.03226.x.Article PubMed

Figure 1

ROC curve of CPOT at pre-exposure to suctioning in intensive care unit patients. (N=61)

Table 1

General and Health related Characteristics of Participants (N=202)

Table 2

Interrater Reliability of Critical Care Pain Observation Tool (N=91)

Table 3

Concurrent Validity of Critical Care Pain Observation Tool (N=202)

CPOT=Critical care pain observation tool; CNPI=Checklist of nonverbal pain indicators.

Table 4

Discriminant Validity: Comparison of CPOT Scores Measured before, During, and after Suctioning (N=202)

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

Cite

CITE: export Copy Download Format; Close

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

Validation of a Korean Translated Version of the Critical Care Pain Observation Tool (CPOT) for ICU Patients

J Korean Acad Nurs. 2012;42(1):76-84. Published online February 29, 2012

DOI: https://doi.org/10.4040/jkan.2012.42.1.76

XML Download

Figure

We recommend

Validation of a Korean Translated Version of the Critical Care Pain Observation Tool (CPOT) for ICU Patients

Figure 1 ROC curve of CPOT at pre-exposure to suctioning in intensive care unit patients. (N=61)

Figure 1

Validation of a Korean Translated Version of the Critical Care Pain Observation Tool (CPOT) for ICU Patients

Table 1

General and Health related Characteristics of Participants (N=202)

Table 2

Interrater Reliability of Critical Care Pain Observation Tool (N=91)

Table 3

Concurrent Validity of Critical Care Pain Observation Tool (N=202)

CPOT=Critical care pain observation tool; CNPI=Checklist of nonverbal pain indicators.

Table 4

Discriminant Validity: Comparison of CPOT Scores Measured before, During, and after Suctioning (N=202)

Table 1 General and Health related Characteristics of Participants (N=202)

Table 2 Interrater Reliability of Critical Care Pain Observation Tool (N=91)

Table 3 Concurrent Validity of Critical Care Pain Observation Tool (N=202)

CPOT=Critical care pain observation tool; CNPI=Checklist of nonverbal pain indicators.

Table 4 Discriminant Validity: Comparison of CPOT Scores Measured before, During, and after Suctioning (N=202)