Validity and Reliability of Behavioral Pain Scale in Patients With Low Level of Consciousness Due to Head Trauma Hospitalized in Intensive Care Unit

Abstract

Background:Estimating pain in patients of intensive care unit (ICU) is essential, but because of their special situation, verbal scales cannot be used. Therefore, to estimate the level of pain, behavioral pain scale was developed by Payen in 2001.Objectives:The aim of this study was to investigate the validity and reliability of behavioral pain scale in patients with low level of consciousness due to head trauma hospitalized in ICU.Patients and Methods:This descriptive prospective study was performed in Yazd in 2013. In this study, fifty patients, including thirteen women and thirty seven men, were involved. To collect the data a questionnaire including demographic and Glasgow coma scale (GCS) information as well as a list of behavioral pain scale (BPS) were used. SPSS software (version 18) was used to analyze the data.Results:There was no significant difference in reliability proving of average score of BPS recorded by two day and night assessors (P > 5). Cronbach’s alpha was 85 for painful procedures and 76 for non-painful procedures. In addition, known groups’ technique (painful and non-painful procedures) was used to assess validity. The average scores were 7.75 during painful procedures and 3.28 during non-painful procedures (P = 0.001). The results stated that BPS scores during these two procedures were significantly different.Conclusions:BPS in patients with low level of consciousness due to head trauma has strong reliability and validity. Therefore, this scale can be used for patients hospitalized in ICU to assess the level of pain.

Comparing the Effects of Suction and Routine Methods on Vital Signs, Arterial Blood Oxygen Saturation and Pain Level of Patients Hospitalized at the Intensive Care Unit

“…The lowest achieved score was three and the highest score was 12 (the highest level of pain) ( Table 1). Validity and reliability of these tools were determined by Dehghani et al on patients with brain injury hospitalized at the ICU (Cronbach's alpha coefficient during painful procedures and non-painful procedures was respectively 0.85 and 0.76); they reported that this tool has appropriate validity and reliability for measuring pain level of brain injury patients who are not able to communicate (12).…”

Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

“…Although both the BPS and the CPOT have been validated across large samples of medical, surgical, and trauma ICUs (50)(51)(52)(53)(54), studies involving brain-injured patients using the BPS (50,51) and CPOT (52)(53)(54) are small. In the brain-injured population, although the construct validity of both scales is supported with higher scores during painful procedures (vs rest and nonpainful procedures), patients predominantly expressed pain-related behaviors that were related to level of consciousness; grimacing and muscle rigidity were less frequently observed (50,(52)(53)(54). An additional study (51), although not evaluating validity, found that BPS and BPS-NI were feasible and reliable to use in the brain-injured population.…”

Automatic Detection of Pain from Facial Expressions: A Survey

“…Therefore, assessment by other people, especially caregivers and nursing staff, is necessary. For this, different observational pain scales such as Behavioral Pain Scale (BPS) [13], Pain Assessment in Advanced Dementia (PAINAD) [14], or Neonatal Infant Pain Scale (NIPS) [15], are used in clinical settings. Facial expressions, body movements, and vocalizations are part of such observational pain scales.…”

“…Given the prominence of facial expressions in the assessment of pain across different age groups and health conditions (cf. [35], [15], [13], [14]), this survey focuses on automatic detection of pain from facial expressions.…”