Evaluation of Two Observational Pain Assessment Tools in Chinese Critically Ill Patients.

OBJECTIVES: To examine and compare the reliability and validity of two observational pain assessment tools used in a sample of Chinese critically ill patients.

DESIGN: A prospective observational study.

SETTING AND SUBJECTS: A convenience sample of 117 adult critically ill patients was recruited from a general Intensive Care Unit in a university-affiliated hospital in China.

METHODS: Pain was assessed before and during painful and nonpainful routine care procedures (suctioning and noninvasive blood pressure measurement, respectively) using the Critical-Care Pain Observation Tool (CPOT) and the Behavioral Pain Scale (BPS), including the original BPS and the BPS for Non-Intubated patients (BPS-NI). Internal consistency, test-retest reliability, interrater reliability, and discriminant validity of the CPOT and the BPS were evaluated, and the two scales compared.

RESULTS: A total of 608 assessments were obtained using the CPOT and the BPS. Overall Cronbach's alpha coefficient for the CPOT and the BPS was 0.795 and 0.791, respectively. Test-retest reliability of the CPOT and the BPS was 0.950 and 0.941, respectively. Overall weighted κ between the two raters of the CPOT and the BPS was 0.973 and 0.955, respectively. Scores of the CPOT and the BPS during the painful procedures were both significantly higher than those during the nonpainful procedures, and those at rest before the painful procedures. There was a strong correlation between the two scales with adequate limits of agreement.

CONCLUSION: Both the CPOT and the BPS are reliable and valid tools to assess pain in intubated and nonintubated critically ill Chinese patients.