The utility of unidimensional and functional pain assessment tools in adult postoperative patients: a systematic review

BACKGROUND: Over 70% of patients hospitalised in an intensive care unit (ICU) often experience moderate to severe pain due to pre-existing diseases, trauma, surgery, aggressive procedures, and routine ICU care. Many patients hospitalised in ICU are not able to speak and express their pain due to various causes, including mechanical ventilation, reduced consciousness, and administration of sedative drugs. Therefore, the use of observational and behavioural pain tools is recommended in this group of patients given their inability to express pain. AIM: To examine the existing observational and behavioural tools for assessment of in Nonverbal Intubated Critically Adult Patients after Open-Heart Surgery. METHODS: A systematic review of available observational and behavioural tools for assessment of pain was undertaken using the COSMIN checklist. A literature search was conducted using the following databases: Ovid, Science Direct, Scopus, PubMed, and CINHAL databases, Google Scholar search engine as well as Persian resources Sid, Magiran, Iran doc, and IranMedex up to the end of 2017 were reviewed. RESULTS: A total of 47 studies that had examined five tools used in intensive care units after cardiac surgery in patients under mechanical ventilation were reviewed. Each of the five tools included behavioural and observational items, and only one tool had physiological items. All the tools had been evaluated regarding validity and reliability. In the three tools, sensitivity, specificity, responsiveness, and satisfaction were considered. CONCLUSION: Based on available evidence and investigations, CPOT and BPS tools have good validity and reliability to be used in pain assessment in Nonverbal Intubated Critically Adult Patients after Open-Heart Surgery. The NVPS tool requires more studies to be further confirmed before the assessment of pain in this group of patients.

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The Impact of Pain Assessment on Critically Ill Patients’ Outcomes: A Systematic Review

BioMed Research International ◽

10.1155/2015/503830 ◽

2015 ◽

Vol 2015 ◽

pp. 1-18 ◽

Cited By ~ 27

Author(s):

Evanthia Georgiou ◽

Maria Hadjibalassi ◽

Ekaterini Lambrinou ◽

Panayiota Andreou ◽

Elizabeth D. E. Papathanassoglou

Keyword(s):

Systematic Review ◽

Pain Management ◽

Quality Assessment ◽

Critically Ill ◽

Pain Assessment ◽

Critically Ill Patients ◽

Methodological Quality ◽

Assessment Tools ◽

Current Evidence ◽

The Impact

In critically ill patients, pain is a major problem. Efficient pain management depends on a systematic, comprehensive assessment of pain. We aimed to review and synthesize current evidence on the impact of a systematic approach to pain assessment on critically ill patients’ outcomes. A systematic review of published studies (CINAHL, PUBMED, SCOPUS, EMBASE, and COCHRANE databases) with predetermined eligibility criteria was undertaken. Methodological quality was assessed by the EPHPP quality assessment tool. A total of 10 eligible studies were identified. Due to big heterogeneity, quantitative synthesis was not feasible. Most studies indicated the frequency, duration of pain assessment, and types of pain assessment tools. Methodological quality assessment yielded “strong” ratings for 5/10 and “weak” ratings for 3/10 studies. Implementation of systematic approaches to pain assessment appears to associate with more frequent documented reports of pain and more efficient decisions for pain management. There was evidence of favorable effects on pain intensity, duration of mechanical ventilation, length of ICU stay, mortality, adverse events, and complications. This systematic review demonstrates a link between systematic pain assessment and outcome in critical illness. However, the current level of evidence is insufficient to draw firm conclusions. More high quality randomized clinical studies are needed.

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Chronic Pain Assessment Tools for Cerebral Palsy: A Systematic Review

PEDIATRICS ◽

10.1542/peds.2015-0273 ◽

2015 ◽

Vol 136 (4) ◽

pp. e947-e960 ◽

Cited By ~ 36

Author(s):

S. Kingsnorth ◽

T. Orava ◽

C. Provvidenza ◽

E. Adler ◽

N. Ami ◽

...

Keyword(s):

Systematic Review ◽

Chronic Pain ◽

Cerebral Palsy ◽

Pain Assessment ◽

Assessment Tools

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O39 Unidimensional and functional pain assessment tools in postoperative adult patients: a systematic review of their development and utility

British Journal of Surgery ◽

10.1093/bjs/znab282.044 ◽

2021 ◽

Vol 108 (Supplement_5) ◽

Author(s):

R M Baamer ◽

A Iqbal ◽

D N Lobo ◽

R D Knaggs ◽

N A Levy ◽

...

Keyword(s):

Measurement Error ◽

Postoperative Pain ◽

Pain Assessment ◽

Rating Scale ◽

Assessment Tools ◽

Measurement Properties ◽

Health Measurement ◽

Functional Pain ◽

The Impact ◽

Quality Evidence

Abstract Introduction The Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), Verbal descriptor scale, and faces pain scale are used to measure postoperative pain in adults. However, their utility in this population has not been reviewed systematically. We aimed to summarise and appraise the evidence relating to the measurement properties of unidimensional tools when used for this population and to identify available tools assessing the impact of pain on the restoration of function. Method Four databases (MEDLINE, EMBASE, CINAHL, PsycINFO) were searched up to August 2020 for relevant studies. Two reviewers independently screened articles and assessed risk of bias using the COensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. Result Thirty-one studies were included. Only one study included an objective pain score; a tool assessing pain interference with function and reported low-quality evidence for construct validity. Studies looked at unidimensional tools were underpinned by low or very low-quality evidence for reliability, and all displayed a low quality of evidence of indeterminate responsiveness. Measurement error was only reported for VAS in one study of moderate quality. Interpretability results were available only for VAS and NRS. Feasibility results varied based on the included population. Conclusion Despite the extensive use of unidimensional tools, there is no evidence to suggest that any of these tools has superior measurement properties for postoperative pain. Therefore, future studies should be prioritised to assess their validity, measurement error and responsiveness. Validation studies of pain assessment tools that promote function are needed. Take-home Message Take home message: Functional pain scores should be assessed and validated for postoperative pain.

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