Aims And Objectives: To validate the Chinese version of the Critical-Care Pain Observation Tool (CPOT) in nonintubated and intubated ICU patients.
Background: While CPOT was found to have the best psychometric properties among objective pain assessment scales, there is no Chinese version CPOT for nonintubated patients.
Design: Cross-sectional design was used in these two observational studies.
Methods: Seventy-six nonintubated patients and 53 intubated patients were assessed to examine internal consistency, criterion-related and discriminative validity of CPOT in the first study. Pain assessment during low pain condition as well as increased pain condition was performed by Numeric Rating Scale (NRS) and the Chinese version COPT. Forty nonintubated patients and 43 intubated patients were assessed to examine inter-rater reliability in the second study. A bedside nurse and a researcher independently executed paired pain assessments with CPOT in the same conditions. The STROBE Statement was followed to guide these studies.
Results: The Cronbach's α in nonintubated patients and intubated patients was 0.903-0.930 and 0.868-0.870. The intraclass correlation coefficients (ICCs) in nonintubated patients ranged from 0.959-0.982, and the ICC in intubated patients ranged from 0.947-0.959, confirming the inter-rater reliability. The moderately positive Pearson's correlations between CPOT and NRS scores (r = 0.757-0.838 in nonintubated patients, r = 0.574-0.705 in intubated patients) indicated the criterion-related validity. A significant increase in CPOT scores in the increased pain condition compared with those acquired in the low pain condition verified the discriminative validity.
Conclusions: The Chinese version of CPOT was presented to be valid and reliable for both nonintubated and intubated critically ill adults, which could be applicable for pain assessment in patients in ICU.
Relevance To Clinical Practice: This study provides an applicable pain assessment tool for both nonintubated patients and intubated patients in ICU.
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http://dx.doi.org/10.1111/jocn.14862 | DOI Listing |
J Intensive Med
January 2025
Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background: Awake prone positioning (APP) can reportedly reduce the need for intubation and help improve prognosis of patients with acute hypoxemic respiratory failure (AHRF) infected with COVID-19. However, its physiological mechanism remains unclear. In this study, we evaluated the effect of APP on lung ventilation in patients with moderate-to-severe AHRF to better understand the effects on ventilation distribution and to prevent intubation in non-intubated patients.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Department for Trauma-, Hand- and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Purpose: Severe thorax trauma including multiple rib fractures and flail chest deformity are leading causes of death in trauma patients. Increasing evidence supports the use of surgical stabilisation of rib fractures (SSRF) in these patients. However, there is currently a paucity of evidence for its use in non-ventilator-dependent patients.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
December 2024
Department of Medical Science, Surgery and Neurosciences, Cardiothoracic and Vascular Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy. Electronic address:
Objective: This study investigated if the serratus anterior plane block (SAPB) within a multimodal analgesia scheme would reduce acute post-operative pain and intravenous opioid consumption in patients admitted to the intensive care unit after isolated minimally invasive mitral valve surgery.
Design: Retrospective study.
Setting: Patients were admitted to the intensive care unit (ICU) of the University Hospital of Siena (Italy).
Curr Opin Crit Care
January 2025
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, University of Milan, Milan, Italy.
Purpose Of Review: The increasing use of prone position, in intubated patients with acute respiratory distress syndrome as well as in patients with acute hypoxemic respiratory failure receiving noninvasive respiratory support, mandates a better definition and monitoring of the response to the manoeuvre. This review will first discuss the definition of the response to prone positioning, which is still largely based on its effect on oxygenation. We will then address monitoring respiratory and hemodynamic responses to prone positioning in intubated patients.
View Article and Find Full Text PDFCrit Care Resusc
December 2024
Australian and New Zealand Intensive Care - Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne Australia.
Objective: To describe the use of and outcomes from awake prone positioning (APP) in nonintubated patients with COVID-19 in Australian intensive care units (ICUs) in comparison to those who did not receive APP, and to explore the temporal relationship between publication of APP research and changes in clinical practice.
Design: Multicentre, observational cohort study.
Setting: Seventy-eight Australian ICUs participating in SPRINT-SARI Australia.
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