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Erschienen in: Die Anaesthesiologie 12/2019

20.11.2019 | Originalien

The German version of the Critical-Care Pain Observation Tool for critically ill adults

A prospective validation study

verfasst von: Dr. med. I. Kiesewetter, MSc, U. Bartels, A. Bauer, G. Schneider, S. Pilge

Erschienen in: Die Anaesthesiologie | Ausgabe 12/2019

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Abstract

Background

The implementation of the Critical-Care Pain Observation tool (CPOT) in intensive care units (ICU) has been associated with more frequent pain assessments, a reduced number of complications, and improved administration of analgesics and sedatives. So far no German translation exists. Translating this tool into foreign languages requires further validation testing.

Objective

The aim of this prospective observational validation study was to translate the original version of the CPOT according to scientific principles for translation and to establish the validity and reliability of the German translation of CPOT for critically ill adult patients.

Material and methods

A total of 292 cardiac surgery patients from 2 ICUs of 2 German university teaching hospitals were included (114 patients at center 1 and 178 patients at center 2). Of the included patients 22.6% were female and 76.4% were male with a mean age of 68.5 years ±9.3 SD. Pain was evaluated with the CPOT, the Bhavioral Pain Scale (BPS) and with the Numeric Rating scale (NRS) at three time points (1. intubated + sedated, 2. intubated + awake, 3. extubated + awake) at rest and during nociceptive stimulus (positioning). Assessments were made separately by trained physicians and nursing staff.

Results

Good results for interrater reliability and internal consistency could be demonstrated (weighted Cohen’s kappa of 0.73, Cronbach’s coefficient alpha of 0.8). Spearman correlation between CPOT and NRS was moderate but significant. The receiver operating characteristic (ROC) analysis to obtain optimal thresholds of CPOT to detect pain revealed different results during rest and stimulus and in intubated and extubated patients.

Conclusion

The validated German CPOT translation is a reliable tool for pain assessment in cardiac ICU patients in the absence of patients’ ability for self-reporting. The use of this German version of CPOT now allows a better international comparability of corresponding data in future studies.
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Literatur
1.
Zurück zum Zitat Anand KJ, Craig KD (1996) New perspectives on the definition of pain. Pain 67:3–6 (discussion 209–211)CrossRef Anand KJ, Craig KD (1996) New perspectives on the definition of pain. Pain 67:3–6 (discussion 209–211)CrossRef
3.
Zurück zum Zitat Barr J, Fraser GL, Puntillo K et al (2013) Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med 41:263–306CrossRef Barr J, Fraser GL, Puntillo K et al (2013) Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med 41:263–306CrossRef
4.
Zurück zum Zitat Chanques G, Jaber S, Barbotte E et al (2006) Impact of systematic evaluation of pain and agitation in an intensive care unit. Crit Care Med 34:1691–1699CrossRef Chanques G, Jaber S, Barbotte E et al (2006) Impact of systematic evaluation of pain and agitation in an intensive care unit. Crit Care Med 34:1691–1699CrossRef
5.
Zurück zum Zitat Desbiens NA, Wu AW, Broste SK et al (1996) Pain and satisfaction with pain control in seriously ill hospitalized adults: findings from the SUPPORT research investigations. Crit Care Med 24:1953–1961CrossRef Desbiens NA, Wu AW, Broste SK et al (1996) Pain and satisfaction with pain control in seriously ill hospitalized adults: findings from the SUPPORT research investigations. Crit Care Med 24:1953–1961CrossRef
6.
Zurück zum Zitat Echegaray-Benites C, Kapoustina O, Gelinas C (2014) Validation of the use of the critical-care pain observation tool (CPOT) with brain surgery patients in the neurosurgical intensive care unit. Intensive Crit Care Nurs 30:257–265CrossRef Echegaray-Benites C, Kapoustina O, Gelinas C (2014) Validation of the use of the critical-care pain observation tool (CPOT) with brain surgery patients in the neurosurgical intensive care unit. Intensive Crit Care Nurs 30:257–265CrossRef
7.
Zurück zum Zitat Frandsen JB, O’reilly Poulsen KS, Laerkner E et al (2016) Validation of the Danish version of the critical care pain observation tool. Acta Anaesthesiol Scand 60:1314–1322CrossRef Frandsen JB, O’reilly Poulsen KS, Laerkner E et al (2016) Validation of the Danish version of the critical care pain observation tool. Acta Anaesthesiol Scand 60:1314–1322CrossRef
8.
Zurück zum Zitat Garcia Lizana F, Peres Bota D, De Cubber M et al (2003) Long-term outcome in ICU patients: what about quality of life? Intensive Care Med 29:1286–1293CrossRef Garcia Lizana F, Peres Bota D, De Cubber M et al (2003) Long-term outcome in ICU patients: what about quality of life? Intensive Care Med 29:1286–1293CrossRef
9.
Zurück zum Zitat Gelinas C, Arbour C, Michaud C et al (2011) Implementation of the critical-care pain observation tool on pain assessment/management nursing practices in an intensive care unit with nonverbal critically ill adults: a before and after study. Int J Nurs Stud 48:1495–1504CrossRef Gelinas C, Arbour C, Michaud C et al (2011) Implementation of the critical-care pain observation tool on pain assessment/management nursing practices in an intensive care unit with nonverbal critically ill adults: a before and after study. Int J Nurs Stud 48:1495–1504CrossRef
10.
Zurück zum Zitat Gelinas C, Fillion L, Puntillo KA et al (2006) Validation of the critical-care pain observation tool in adult patients. Am J Crit Care 15:420–427PubMed Gelinas C, Fillion L, Puntillo KA et al (2006) Validation of the critical-care pain observation tool in adult patients. Am J Crit Care 15:420–427PubMed
11.
Zurück zum Zitat Gelinas C, Harel F, Fillion L et al (2009) Sensitivity and specificity of the critical-care pain observation tool for the detection of pain in intubated adults after cardiac surgery. J Pain Symptom Manage 37:58–67CrossRef Gelinas C, Harel F, Fillion L et al (2009) Sensitivity and specificity of the critical-care pain observation tool for the detection of pain in intubated adults after cardiac surgery. J Pain Symptom Manage 37:58–67CrossRef
12.
Zurück zum Zitat Gelinas C, Johnston C (2007) Pain assessment in the critically ill ventilated adult: validation of the critical-care pain observation tool and physiologic indicators. Clin J Pain 23:497–505CrossRef Gelinas C, Johnston C (2007) Pain assessment in the critically ill ventilated adult: validation of the critical-care pain observation tool and physiologic indicators. Clin J Pain 23:497–505CrossRef
13.
Zurück zum Zitat Gerbershagen HJ, Rothaug J, Kalkman CJ et al (2011) Determination of moderate-to-severe postoperative pain on the numeric rating scale: a cut-off point analysis applying four different methods. Br J Anaesth 107:619–626CrossRef Gerbershagen HJ, Rothaug J, Kalkman CJ et al (2011) Determination of moderate-to-severe postoperative pain on the numeric rating scale: a cut-off point analysis applying four different methods. Br J Anaesth 107:619–626CrossRef
14.
Zurück zum Zitat Hjermstad MJ, Fayers PM, Haugen DF et al (2011) Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage 41:1073–1093CrossRef Hjermstad MJ, Fayers PM, Haugen DF et al (2011) Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage 41:1073–1093CrossRef
15.
Zurück zum Zitat Hsiung NH, Yang Y, Lee MS et al (2016) Translation, adaptation, and validation of the behavioral pain scale and the critical-care pain observational tools in Taiwan. J Pain Res 9:661–669CrossRef Hsiung NH, Yang Y, Lee MS et al (2016) Translation, adaptation, and validation of the behavioral pain scale and the critical-care pain observational tools in Taiwan. J Pain Res 9:661–669CrossRef
16.
Zurück zum Zitat Kotfis K, Zegan-Baranska M, Szydlowski L et al (2017) Methods of pain assessment in adult intensive care unit patients—Polish version of the CPOT (Critical Care Pain Observation Tool) and BPS (Behavioral Pain Scale). Anaesthesiol Intensive Ther 49:66–72CrossRef Kotfis K, Zegan-Baranska M, Szydlowski L et al (2017) Methods of pain assessment in adult intensive care unit patients—Polish version of the CPOT (Critical Care Pain Observation Tool) and BPS (Behavioral Pain Scale). Anaesthesiol Intensive Ther 49:66–72CrossRef
17.
Zurück zum Zitat Kwak EM, Oh H (2012) Validation of a Korean translated version of the critical care pain observation tool (CPOT) for ICU patients. J Korean Acad Nurs 42:76–84CrossRef Kwak EM, Oh H (2012) Validation of a Korean translated version of the critical care pain observation tool (CPOT) for ICU patients. J Korean Acad Nurs 42:76–84CrossRef
18.
Zurück zum Zitat Li Q, Wan X, Gu C et al (2014) Pain assessment using the critical-care pain observation tool in Chinese critically ill ventilated adults. J Pain Symptom Manage 48:975–982CrossRef Li Q, Wan X, Gu C et al (2014) Pain assessment using the critical-care pain observation tool in Chinese critically ill ventilated adults. J Pain Symptom Manage 48:975–982CrossRef
20.
Zurück zum Zitat Nurnberg Damstrom D, Saboonchi F, Sackey PV et al (2011) A preliminary validation of the Swedish version of the critical-care pain observation tool in adults. Acta Anaesthesiol Scand 55:379–386CrossRef Nurnberg Damstrom D, Saboonchi F, Sackey PV et al (2011) A preliminary validation of the Swedish version of the critical-care pain observation tool in adults. Acta Anaesthesiol Scand 55:379–386CrossRef
21.
Zurück zum Zitat Payen JF, Bosson JL, Chanques G et al (2009) Pain assessment is associated with decreased duration of mechanical ventilation in the intensive care unit: a post Hoc analysis of the DOLOREA study. Anesthesiology 111:1308–1316CrossRef Payen JF, Bosson JL, Chanques G et al (2009) Pain assessment is associated with decreased duration of mechanical ventilation in the intensive care unit: a post Hoc analysis of the DOLOREA study. Anesthesiology 111:1308–1316CrossRef
22.
Zurück zum Zitat Puntillo K, Pasero C, Li D et al (2009) Evaluation of pain in ICU patients. Chest 135:1069–1074CrossRef Puntillo K, Pasero C, Li D et al (2009) Evaluation of pain in ICU patients. Chest 135:1069–1074CrossRef
23.
Zurück zum Zitat Research AFHCPA (1992) Acute pain management: operative or medical procedures and trauma, part 1. Agency for health care policy and research. Clin Pharm 11:309–331 Research AFHCPA (1992) Acute pain management: operative or medical procedures and trauma, part 1. Agency for health care policy and research. Clin Pharm 11:309–331
24.
Zurück zum Zitat Rijkenberg S, Stilma W, Bosman RJ et al (2017) Pain measurement in mechanically ventilated patients after cardiac surgery: comparison of the behavioral pain scale (BPS) and the critical-care pain observation tool (CPOT). J Cardiothorac Vasc Anesth 31:1227–1234CrossRef Rijkenberg S, Stilma W, Bosman RJ et al (2017) Pain measurement in mechanically ventilated patients after cardiac surgery: comparison of the behavioral pain scale (BPS) and the critical-care pain observation tool (CPOT). J Cardiothorac Vasc Anesth 31:1227–1234CrossRef
25.
Zurück zum Zitat Rijkenberg S, Van Der Voort PH (2016) Can the critical-care pain observation tool (CPOT) be used to assess pain in delirious ICU patients? J Thorac Dis 8:E285–E287CrossRef Rijkenberg S, Van Der Voort PH (2016) Can the critical-care pain observation tool (CPOT) be used to assess pain in delirious ICU patients? J Thorac Dis 8:E285–E287CrossRef
27.
Zurück zum Zitat Sulla F, De Souza Ramos N, Terzi N et al (2017) Validation of the Italian version of the critical pain observation tool in brain-injured critically ill adults. Acta Biomed 88:48–54PubMedPubMedCentral Sulla F, De Souza Ramos N, Terzi N et al (2017) Validation of the Italian version of the critical pain observation tool in brain-injured critically ill adults. Acta Biomed 88:48–54PubMedPubMedCentral
28.
Zurück zum Zitat Van Der Woude MC, Bormans L, Hofhuis JG et al (2016) Current use of pain scores in Dutch intensive care units: a postal survey in the Netherlands. Anesth Analg 122:456–461CrossRef Van Der Woude MC, Bormans L, Hofhuis JG et al (2016) Current use of pain scores in Dutch intensive care units: a postal survey in the Netherlands. Anesth Analg 122:456–461CrossRef
29.
Zurück zum Zitat Van Gulik L, Ahlers SJ, Brkic Z et al (2010) Improved analgesia after the realisation of a pain management programme in ICU patients after cardiac surgery. Eur J Anaesthesiol 27:900–905CrossRef Van Gulik L, Ahlers SJ, Brkic Z et al (2010) Improved analgesia after the realisation of a pain management programme in ICU patients after cardiac surgery. Eur J Anaesthesiol 27:900–905CrossRef
30.
Zurück zum Zitat Vazquez Calatayud M, Pardavila Belio MI, Lucia Maldonado M et al (2009) Evaluation of pain during posture change in patients with invasive mechanical ventilation. Enferm Intensiva 20:2–9CrossRef Vazquez Calatayud M, Pardavila Belio MI, Lucia Maldonado M et al (2009) Evaluation of pain during posture change in patients with invasive mechanical ventilation. Enferm Intensiva 20:2–9CrossRef
31.
Zurück zum Zitat Wild D, Grove A, Martin M et al (2005) Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health 8:94–104CrossRef Wild D, Grove A, Martin M et al (2005) Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health 8:94–104CrossRef
Metadaten
Titel
The German version of the Critical-Care Pain Observation Tool for critically ill adults
A prospective validation study
verfasst von
Dr. med. I. Kiesewetter, MSc
U. Bartels
A. Bauer
G. Schneider
S. Pilge
Publikationsdatum
20.11.2019
Verlag
Springer Medizin
Erschienen in
Die Anaesthesiologie / Ausgabe 12/2019
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-019-00694-5

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