scholarly journals A Psychometric Analysis Update of Behavioral Pain Assessment Tools for Noncommunicative, Critically Ill Adults

2019 ◽  
Vol 30 (4) ◽  
pp. 365-387 ◽  
Author(s):  
Céline Gélinas ◽  
Aaron M. Joffe ◽  
Paul M. Szumita ◽  
Jean-Francois Payen ◽  
Mélanie Bérubé ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Critically Ill ◽  
Pain Assessment ◽  
Pain Scale ◽  
Assessment Tools ◽  
Process Reliability ◽  
Behavioral Pain Scale ◽  
Critically Ill Adults ◽  
Ill Adults

This is an updated, comprehensive review of the psychometric properties of behavioral pain assessment tools for use with noncommunicative, critically ill adults. Articles were searched in 5 health databases. A total of 106 articles were analyzed, including 54 recently published papers. Nine behavioral pain assessment tools developed for noncommunicative critically ill adults and 4 tools developed for other non-communicative populations were included. The scale development process, reliability, validity, feasibility, and clinical utility were analyzed using a 0 to 20 scoring system, and quality of evidence was also evaluated. The Behavioral Pain Scale, the Behavioral Pain Scale-Nonintubated, and the Critical-Care Pain Observation Tool remain the tools with the strongest psychometric properties, with validation testing having been conducted in multiple countries and various languages. Other tools may be good alternatives, but additional research on them is necessary.

scholarly journals Validation of Two Pain Assessment Tools Using a Standardized Nociceptive Stimulation in Critically Ill Adults

2018 ◽  
Vol 56 (4) ◽  
pp. 594-601 ◽  
Author(s):  
Cristini Klein ◽  
Wolnei Caumo ◽  
Céline Gélinas ◽  
Valéria Patines ◽  
Tatiana Pilger ◽  
...  
Keyword(s):  
Critically Ill ◽  
Pain Assessment ◽  
Assessment Tools ◽  
Nociceptive Stimulation ◽  
Critically Ill Adults ◽  
Ill Adults

Delirium Assessment Tools for Use in Critically Ill Adults: A Psychometric Analysis and Systematic Review

2018 ◽  
Vol 38 (1) ◽  
pp. 38-49 ◽  
Author(s):  
Céline Gélinas ◽  
Mélanie Bérubé ◽  
Annie Chevrier ◽  
Brenda T. Pun ◽  
E. Wesley Ely ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Assessment Tools ◽  
Cognitive Test ◽  
Delirium Assessment ◽  
Nursing Delirium Screening Scale ◽  
Detection Score ◽  
Critically Ill Adults ◽  
Ill Adults

BACKGROUNDDelirium is highly prevalent in critically ill patients. Its detection with valid tools is crucial.OBJECTIVETo analyze the development and psychometric properties of delirium assessment tools for critically ill adults.METHODSDatabases were searched to identify relevant studies. Inclusion criteria were English language, publication before January 2015, 30 or more patients, and patient population of critically ill adults (>18 years old). Search terms were delirium, scales, critically ill patients, adult, validity, and reliability. Thirty-six manuscripts were identified, encompassing 5 delirium assessment tools (Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Cognitive Test for Delirium, Delirium Detection Score, Intensive Care Delirium Screening Checklist (ICDSC), and Nursing Delirium Screening Scale). Two independent reviewers analyzed the psychometric properties of these tools by using a standardized scoring system (range, 0–20) to assess the tool development process, reliability, validity, feasibility, and implementation of each tool.RESULTSPsychometric properties were very good for the CAM-ICU (19.6) and the ICDSC (19.2), moderate for the Nursing Delirium Screening Scale (13.6), low for the Delirium Detection Score (11.2), and very low for the Cognitive Test for Delirium (8.2).CONCLUSIONSThe results indicate that the CAM-ICU and the ICDSC are the most valid and reliable delirium assessment tools for critically ill adults. Additional studies are needed to further validate these tools in critically ill patients with neurological disorders and those at various levels of sedation or consciousness.

Comparison of Self-Reported and Behavioral Pain Assessment Tools in Critically Ill Patients

2018 ◽  
Vol 35 (5) ◽  
pp. 453-460 ◽  
Author(s):  
Rima H. Bouajram ◽  
Christian M. Sebat ◽  
Dawn Love ◽  
Erin L. Louie ◽  
Machelle D. Wilson ◽  
...  
Keyword(s):  
Critically Ill ◽  
Pain Assessment ◽  
Critically Ill Patients ◽  
Strong Correlation ◽  
Rating Scale ◽  
Assessment Method ◽  
Pain Scale ◽  
Assessment Tools ◽  
Pain Scales ◽  
Behavioral Pain Scale

Background:Self-reported and behavioral pain assessment scales are often used interchangeably in critically ill patients due to fluctuations in mental status. The correlation between scales is not well elucidated. The purpose of this study was to describe the correlation between self-reported and behavioral pain scores in critically ill patients.Methods:Pain was assessed using behavioral and self-reported pain assessment tools. Behavioral pain tools included Critical Care Pain Observation Tool (CPOT) and Behavioral Pain Scale (BPS). Self-reported pain tools included Numeric Rating Scale (NRS) and Wong-Baker Faces Pain Scales. Delirium was assessed using the confusion assessment method for the intensive care unit. Patient preference regarding pain assessment method was queried. Correlation between scores was evaluated.Results:A total of 115 patients were included: 67 patients were nondelirious and 48 patients were delirious. The overall correlation between self-reported (NRS) and behavioral (CPOT) pain scales was poor (0.30, P = .018). In patients without delirium, a strong correlation was found between the 2 behavioral pain scales (0.94, P < .0001) and 2 self-reported pain scales (0.77, P < .0001). Self-reported pain scale (NRS) and behavioral pain scale (CPOT) were poorly correlated with each other (0.28, P = .021). In patients with delirium, there was a strong correlation between behavioral pain scales (0.86, P < .0001) and a moderate correlation between self-reported pain scales (0.69, P < .0001). There was no apparent correlation between self-reported (NRS) and behavioral pain scales (CPOT) in patients with delirium (0.23, P = .12). Most participants preferred self-reported pain assessment.Conclusion:Self-reported pain scales and behavioral pain scales cannot be used interchangeably. Current validated behavioral pain scales may not accurately reflect self-reported pain in critically ill patients.

Evaluation of the quality of evidence supporting guideline recommendations for the nutritional management of critically ill adults

2020 ◽  
Vol 39 ◽  
pp. 144-149
Author(s):  
Elena Xu ◽  
Sofia Tejada ◽  
Candela Solé-Lleonart ◽  
Laura Campogiani ◽  
Francisco Valenzuela-Sanchez ◽  
...  
Keyword(s):  
Critically Ill ◽  
Nutritional Management ◽  
Quality Of Evidence ◽  
Critically Ill Adults ◽  
Ill Adults

Evaluation of Pain Assessment Tools in Patients Receiving Mechanical Ventilation

2016 ◽  
Vol 27 (2) ◽  
pp. 162-172 ◽  
Author(s):  
Zainab Q. Al Darwish ◽  
Radwa Hamdi ◽  
Summayah Fallatah
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Pain Assessment ◽  
Descriptive Study ◽  
Pain Scale ◽  
Assessment Tools ◽  
Highly Sensitive ◽  
Sensitive Tool ◽  
P 16 ◽  
Behavioral Pain Scale

Pain assessment poses a great challenge for clinicians in intensive care units. This descriptive study aimed to find the most reliable, sensitive, and valid tool for assessing pain. The researcher and a nurse simultaneously assessed 47 nonverbal patients receiving mechanical ventilation in the intensive care unit by using 3 tools: the Behavioral Pain Scale (BPS), the Critical-Care Pain Observation Tool (CPOT), and the adult Nonverbal Pain Scale (NVPS) before, during, and after turning and suctioning. All tools were found to be reliable and valid (Cronbach α = 0.95 for both the BPS and the CPOT, α = 0.86 for the NVPS), and all subscales of both the BPS and CPOT were highly sensitive for assessing pain (P &lt; .001). The NVPS physiology (P = .21) and respiratory (P = .16) subscales were not sensitive for assessing pain. The BPS was the most reliable, valid, and sensitive tool, with the CPOT considered an appropriate alternative tool for assessing pain. The NVPS is not recommended because of its inconsistent psychometric properties.

Long-Term Quality of Life After Extracorporeal Membrane Oxygenation in ARDS Survivors: Systematic Review and Meta-Analysis

2017 ◽  
Vol 35 (3) ◽  
pp. 233-243 ◽  
Author(s):  
M. Elizabeth Wilcox ◽  
Valente Jaramillo-Rocha ◽  
Carol Hodgson ◽  
Michael S. Taglione ◽  
Niall D. Ferguson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Extracorporeal Membrane Oxygenation ◽  
Critically Ill ◽  
Observational Studies ◽  
Membrane Oxygenation ◽  
Critically Ill Adults ◽  
The Impact ◽  
Ill Adults

Purpose: Extracorporeal membrane oxygenation (ECMO) is an increasingly prevalent treatment for acute respiratory failure (ARF). To evaluate the impact of ECMO support on long-term outcomes for critically ill adults with ARF. Methods: We searched electronic databases 1948 through to November 30 2016; selected controlled trials or observational studies of critically ill adults with acute respiratory distress syndrome, examining long-term morbidity specifically health-related quality of life (HRQL); 2 authors independently selected studies, extracted data, and assessed methodological quality. Analysis: Of the 633 citations, 1 randomized controlled trial and 5 observational studies met the selection criteria. Overall quality of observational studies was moderate to high (mean score on Newcastle-Ottawa scale, 7.2/9; range, 6-8). In 3 studies (n = 245), greater decrements in HRQL were seen for survivors of ECMO when compared to survivors of conventional mechanical ventilation (CMV) as measured by the Short Form 36 (SF-36) scores ([ECMO-CMV]: 5.40 [95% confidence interval, CI, 4.11 to 6.68]). As compared to CMV survivors, those who received ECMO experienced significantly less psychological morbidity (2 studies; n = 217 [ECMO-CMV]: mean weighted difference [MWD], −1.31 [95% CI, −1.98 to −0.64] for depression and MWD, −1.60 [95% CI, −1.80 to −1.39] for anxiety). Conclusions: Further studies are required to confirm findings and determine prognostic factors associated with more favorable outcomes in survivors of ECMO.

scholarly journals The efficacy and safety of prokinetics in critically ill adults receiving gastric feeding tubes: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245317
Author(s):  
Rong Peng ◽  
Hailong Li ◽  
Lijun Yang ◽  
Linan Zeng ◽  
Qiusha Yi ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Critically Ill ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Efficacy And Safety ◽  
Feeding Tubes ◽  
Gastric Feeding ◽  
Critically Ill Adults ◽  
Ill Adults

Background Intolerance to gastric feeding tubes is common among critically ill adults and may increase morbidity. Administration of prokinetics in the ICU is common. However, the efficacy and safety of prokinetics are unclear in critically ill adults with gastric feeding tubes. We conducted a systematic review to determine the efficacy and safety of prokinetics for improving gastric feeding tube tolerance in critically ill adults. Methods Randomized controlled trials (RCTs) were identified by systematically searching the Medline, Cochrane and Embase databases. Two independent reviewers extracted the relevant data and assessed the quality of the studies. We calculated pooled relative risks (RRs) for dichotomous outcomes and the mean differences (MDs) for continuous outcomes with the corresponding 95% confidence intervals (CIs). We assessed the risk of bias using the Cochrane risk-of-bias tool and used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to rate the quality of the evidence. Results Fifteen RCTs met the inclusion criteria. A total of 10 RCTs involving 846 participants were eligible for the quantitative analysis. Most studies (10 of 13, 76.92%) showed that prokinetics had beneficial effects on feeding intolerance in critically ill adults. In critically ill adults receiving gastric feeding, prokinetic agents may reduce the ICU length of stay (MD -2.03, 95% CI -3.96, -0.10; P = 0.04; low certainty) and the hospital length of stay (MD -3.21, 95% CI -5.35, -1.06; P = 0.003; low certainty). However, prokinetics failed to improve the outcomes of reported adverse events and all-cause mortality. Conclusion As a class of drugs, prokinetics may improve tolerance to gastric feeding to some extent in critically ill adults. However, the certainty of the evidence suggesting that prokinetics reduce the ICU or hospital length of stay is low. Prokinetics did not significantly decrease the risks of reported adverse events or all-cause mortality among critically ill adults.

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