Validation of the Critical-Care Pain Observation Tool in Adult Critically Ill Patients

Abstract

The CPOT is an acceptable behavioral pain assessment scale for use in the general critical care patient population and is more appropriate for use with adults than the FLACC.

Validation of the Danish version of the Critical Care Pain Observation Tool

“…The vast majority of patients included in this study were intubated and awake, with RASS scores between À1 to +1 despite severe illness. 24,33,[35][36][37] G elinas et al concluded in their study that patients' bodily behavior was more visible and obvious in the conscious patient group compared to the sedated group. [36][37][38] We did not find any correlation between physiologic indicators and CPOT scores.…”

“…24 The patients' severe illness and treatment can enable their capability to self-report pain even though they are not sedated. 24,[31][32][33][34][35][36][37][38][39] International guidelines recommend valid pain assessment tools, but emphasize the importance of proper validation and testing before implementing the assessment method in clinical practice. 13,25 Therefore, validated pain assessment tools have been developed.…”

Pain Assessment in Noncommunicative Adult Palliative Care Patients

“…As neurosurgical and delirium populations are frequently encountered in critical care and palliative care patient populations, these studies should be replicated removing the confounder of language. Numerous investigators have conducted studies comparing the CPOT to other behavioral pain assessment tools in intensive care units of various types 18,27,46-48 . In most studies, the CPOT performed as well or better than other tools although it did not perform well in the burn population which could self-report 49 .…”

“…Based on the combined sample data, the authors suggested that the FLACC might be useful across populations and settings. Two studies, one comparing the FLACC to the CPOT and Nonverbal Pain Scale (see below) 54 , and the other comparing the FLACC to the CPOT 46 inexplicably omitted data on the FLACC and focused almost exclusively on the CPOT, thus adding little to knowledge about the FLACC. Although Buttes et al 46 noted that the two study data collectors thought the CPOT was more appropriate for adults than the FLACC, they did not present an explanation to support this statement.…”

“…Two studies, one comparing the FLACC to the CPOT and Nonverbal Pain Scale (see below) 54 , and the other comparing the FLACC to the CPOT 46 inexplicably omitted data on the FLACC and focused almost exclusively on the CPOT, thus adding little to knowledge about the FLACC. Although Buttes et al 46 noted that the two study data collectors thought the CPOT was more appropriate for adults than the FLACC, they did not present an explanation to support this statement. With minimal empirical data on the reliability, validity, and clinical utility of the FLACC pain tool in adult populations, particularly those in palliative care, it is unclear whether the FLACC is suitable for assessing pain in palliative care adults across settings and further study is warranted.…”