Translation and cultural adaptation of the Brazilian Portuguese version of the Behavioral Pain Scale

Abstract

ObjectiveThe objective of this study was to translate and culturally adapt the Behavioral Pain Scale to Brazilian Portuguese and to evaluate the psychometric properties of this scale.MethodsThis study was conducted in two phases: the Behavioral Pain Scale was translated and culturally adapted to Brazilian Portuguese and the psychometric properties of this scale were subsequently assessed (reliability and clinical utility). The study sample consisted of 100 patients who were older than 18 years of age, admitted to an intensive care unit, intubated, mechanically ventilated, and subjected or not to sedation and analgesia from July 2012 to December 2012. Pediatric and non-intubated patients were excluded. The study was conducted at a large private hospital that was situated in the city of São Paulo (SP).ResultsRegarding reproducibility, the results revealed that the observed agreement between the two evaluators was 92.08% for the pain descriptor “adaptation to mechanical ventilation”, 88.1% for “upper limbs”, and 90.1% for “facial expression”. The kappa coefficient of agreement for “adaptation to mechanical ventilation” assumed a value of 0.740. Good agreement was observed between the evaluators with an intraclass correlation coefficient of 0.807 (95% confidence interval: 0.727-0.866).ConclusionThe Behavioral Pain Scale was easy to administer and reproduce. Additionally, this scale had adequate internal consistency. The Behavioral Pain Scale was satisfactorily adapted to Brazilian Portuguese for the assessment of pain in critically ill patients.

Pain assessment in critical patients using the Behavioral Pain Scale

“…These procedures are already part of the patient care routine, so no additional procedure is required. Simultaneously, the researchers applied the BPS validated in Brazil by Morete et al 14 (Table 1). The BPS has a total of 12 descriptors, distributed in 3 items (1.…”

“…Upper limbs, 3. Adaptation to mechanical ventilation) 7,14 with results varying from 3 (absence of pain) to 12 (unbearable pain) 13 . A score >3 indicates the presence of pain and ≥5 indicates significant pain 21 .…”

“…As the inability to report pain does not deny its existence and does not discard the right to adequate treatment 11 , when it is impossible to obtain the patient's self-report about the pain it is recommended to use observational scales 12 that are based on the individual's physiological parameters and body expressions. Among the available scales to measure the pain in non-responsive patients, the most used by the health services is the Behavioral Pain Scale (BPS) because it is highly accurate and easy to apply to patients with severe pain 13,14 . Knowing the level of pain of patients, whether critical or not, is essential to optimize comfort and minimize suffering 15 .…”

Avaliação dos níveis álgicos de pacientes críticos em terapia intensiva, antes, durante e após sessão de fisioterapia respiratória: um estudo piloto

“…Cada indicador é classificado em quatro descrições do comportamento, indicando a ausência de dor (pontuação 1) ao máximo de dor (pontuação 4); dessa maneira, a pontuação final varia entre 3 (sem dor) e 12 pontos (dor máxima). O instrumento é de fácil reprodutividade, com tempo máximo de aplicação de dois a cinco minutos, sendo importante para nortear as condutas mais adequadas [12].…”

“…A avaliação da dor no ambiente de UTI é particularmente complexa, visto que grande parte dos instrumentos de avaliação da dor no adulto consistem no auto relato dos pacientes, que em situações críticas estão frequentemente incapazes ou impossibilitados de se comunicar verbalmente, principalmente por causa de intubação traqueal e alterações de consciência [12]. Com base nessa dificuldade, várias escalas estão sendo desenvolvidas para avaliar a dor em pacientes sob ventilação mecânica, como a Critical-Care Pain Observation Tool [13], a Pain Assessment and Intervention Notation Algoritm [14] e a Behavioral Pain Scale (BPS) [15].…”