Validity and Reliability of the Critical Care Pain Observation Tool: A Replication Study

Keane, Kathleen

doi:10.1016/j.pmn.2012.01.002

Cited by 28 publications

(31 citation statements)

References 46 publications

(4 reference statements)

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“…This difference indicates that the CPOT measures pain when pain is present. The result indicates that the Norwegian version of the CPOT has good discriminant validity, which corresponds with results from previous studies (16,24,25,31,32).…”

Section: Discussionsupporting

confidence: 90%

“…This is in line with recommendations from similar studies that emphasise that training the nurses is crucial to the tool's reliability and validity in practice (25,33). The six nurses in the study had identical training in the use of the tool.…”

Section: Assessment Training Usefulsupporting

confidence: 85%

“…In connection with the instruction video the nurses were able to score patient situations and have a discussion in order to arrive at a common understanding of the various domains. More practice in scoring the tool and a better common understanding may have resulted in improved agreement in the scores also during turning.We have not found any earlier comparable studies that have investigated agreement (interrater reliability) between the nurses' CPOT score in each domain (16,24,25,31,32).The analysis of weighted kappa at domain level showed moderate to excellent agreement.Facial expression was the domain with the lowest agreement level between the nurses' score at rest, with weighted kappa value of 0.41. A possible explanation is that the three response alternatives for facial expressions may be hard to distinguish.…”

mentioning

confidence: 57%

“…We have not found any earlier comparable studies that have investigated agreement (interrater reliability) between the nurses' CPOT score in each domain (16,24,25,31,32).…”

Section: Assessment Training Usefulmentioning

confidence: 76%

“…We used similar analysis as in earlier studies in order to compare the results (16,24,25). The CPOT can be regarded as having both categorical and continuous data, which is significant for the choice of analysis method (26).…”

Section: Discussionmentioning

confidence: 99%

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CPOT – verktøy for smertevurdering av intensivpasienter

Storsveen¹,

Hall‐Lord²

2016

Sykepleien

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SUMMARYIntroduction: Research shows that intensive care patients experience pain both at rest and during procedures. Critically ill patients frequently have impaired ability to communicate pain and discomfort, making pain assessment and pain management challenging. Systematic pain assessment with valid tools is essential for good pain management. The Critical-Care Pain Observation Tool (CPOT) is a pain assessment tool with four domains.Objective: To translate The Critical-Care Pain Observation Tool (CPOT) and to examine the tool's validity and reliability.Method: The study has a descriptive quantitative design. The CPOT was first translated into Norwegian using an internationally recommended translation process. Six intensive care nurses were given a one-hour training session in the use of the CPOT, and an instruction video was used to achieve a common understanding of the CPOT scoring system. Independently, two intensive care nurses (in pairs) assessed and scored the patient's pain expression, using the CPOT, before and during a turning procedure. A total of 182 (91 pairwise) CPOT assessments were performed of 18 intensive care patients on mechanical ventilation. The Norwegian version of the CPOT was examined for discriminant validity by comparing the nurses' scores before and during the turning procedure. Research shows that intensive care patients frequently suffer from undertreatment of pain (1)(2)(3)(4)(5). Undertreatment of pain can have serious physical and psychological consequences (6-8). The golden standard for pain assessment is the patient's own description of pain (9, 10). However, the intensive care patient's impaired ability to communicate entails that the patient may experience pain without being able to express it in a way that health care personnel comprehend (4, 7, 11). Patients' inability to self-report pain hinders effective pain management.Systematic pain assessment with valid tools has proven essential to good pain treatment and may be used as a quality indicator of clinical practice (12, 13). There are several tools for assessing pain in adult intensive care patients, but according to international clinical guidelines (14), The Behavior Pain Scale (BPS) (15) and The Critical-Care Pain Observational Tool (CPOT) (16,17) have the highest validity and reliability. Rijkenberg et al. compared the CPOT and the BPS and concluded with a preference for the CPOT, due to better discriminant validity, meaning the tool measures pain better when the intensive care patient is assumed to have pain (19).In the international clinical guidelines, Barr et al. refer to the testing of the two tools' psychometric characteristics (measurement characteristics, user friendliness, the tool's validity and reliability, etc.). The CPOT appeared to be somewhat better, but both the CPOT and the BPS are equally recommended (14). The guidelines recommend that the CPOT and the BPS be translated and validated into more languages (14). The BPS is translated into Norwegian and tested for reliability by Olsen and Rustøen (18). ...

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Section: Discussionsupporting

confidence: 90%

Section: Assessment Training Usefulsupporting

confidence: 85%

mentioning

confidence: 57%

“…We have not found any earlier comparable studies that have investigated agreement (interrater reliability) between the nurses' CPOT score in each domain (16,24,25,31,32).…”

Section: Assessment Training Usefulmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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CPOT – verktøy for smertevurdering av intensivpasienter

Storsveen¹,

Hall‐Lord²

2016

Sykepleien

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The role of intravenous acetaminophen in post‐operative pain control in head and neck cancer patients

Smith

Lange

Moore

et al. 2019

Laryngoscope Investig Oto

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Objective This study investigated the role of intravenous acetaminophen for alleviation of postoperative pain after surgical resection of head and neck cancers. Methods A single‐center study was conducted, which investigated a prospective group of 48 participants who underwent surgery between April 2016 and May 2017 and postoperatively received scheduled IV acetaminophen (1 g every 6 hours for 4 doses) plus the standard opioid PCA and breakthrough narcotics. These were compared to a similar retrospective cohort of 51 patients who had surgery between January 2014 to March 2015 and only received an opioid patient controlled analgesia (PCA) pump and breakthrough narcotics. Outcome measures included averaged pain scores, total amount of narcotics received (in morphine equivalents), and number of PCA attempts measured in 8‐hour intervals over the first 24 hours, as well as duration of PCA and length of stay. Statistical measures included descriptive analysis and gamma regression analysis. Results The acetaminophen group achieved equally low pain scores (0.8 ± 1.2 vs. 1.0 ± 1.3, P = .408) with significantly less total narcotics in the first 8 hours after surgery (13.5 ± 13.3 vs. 22.5 ± 21.5 MEs, P = .014). This group had a significantly decreased length of stay (7.8 ± 4.6 vs. 10.6 ± 7.6 days, P = .03). Conclusion This study demonstrates that intravenous acetaminophen may play a role in reducing the total narcotic requirement in the first 8 hours after surgery and contribute to a decreased length of stay and potentially decrease cost to the patient and hospital overall. Future research should be aimed at comparing these groups in a randomized control study/setting. Level of Evidence 3

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Pain Assessment in Noncommunicative Adult Palliative Care Patients

McGuire

Kaiser

Haisfield-Wolfe

et al. 2016

Nursing Clinics of North America

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Synopsis Palliative care patients who have pain are often unable to self-report their pain placing them at increased risk for under-recognized and under-treated pain. Use of appropriate pain assessment tools significantly enhances the likelihood of effective pain management and improved pain-related outcomes. This paper reviews selected tools and provides palliative care clinicians with a practical approach to selecting a pain assessment tool for non-communicative adult patients.

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Validity and Reliability of the Critical Care Pain Observation Tool: A Replication Study

Cited by 28 publications

References 46 publications

CPOT – verktøy for smertevurdering av intensivpasienter

CPOT – verktøy for smertevurdering av intensivpasienter

The role of intravenous acetaminophen in post‐operative pain control in head and neck cancer patients

Pain Assessment in Noncommunicative Adult Palliative Care Patients

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