NOPPAIN-Br cognitive debriefing and reliability

Abstract

Objectives To perform cognitive debriefing and test the Non-Communicative Patient’s Pain Instrument (NOPPAIN) reliability. Methods This is a methodological study to verify NOPPAIN adapted to the Brazilian culture. Cognitive debriefing: 56 healthcare professionals and caregivers participated; its task was to assess and make suggestions about NOPPAIN-Br equivalence and adequacy. The final version entitled “NOPPAIN-Versão brasileira” was submitted to a committee of experts (n=8). The Content Validity Index was calculated. To test reliability, three observers applied the new version of NOPPAIN to a sample (n=171) of older adults with dementia and impaired communication where interobserver agreement was calculated - KAPPA. Results NOPPAIN-Br was changed in words such as “não comunicativo”, “enfermeiro”, “deve fazer” and “paciente”. The equivalence of the new version with the original instrument was reinforced (CVI>0.80). Interobserver agreement was almost perfect for “Activity Checklist I” (Kappa>0.80), “Pain Behaviors II: Presence” (Kappa>0.80) and “Pain Behaviors III: Intensity” (Kappa>0.80; ICCsingle>0.75). Evidence of high reliability (ICCsingle>0.75) was observed for all subscales of the instrument and total score. The best agreement was for general pain intensity (ICCsingle 0.97). Conclusion NOPPAIN-Br is equivalent to the original and reliable instrument and can be made available for further research and assessment of pain in Brazilians with dementia and impaired communication.