“Gold standard” in the assessment of pain is patient’s subjective assessment by means of standardized
numerical, analog-visual or verbal scales. Unconscious, sedated, mechanically ventilated patients are able to
subjectively assess pain in this way. Clinical practice guidelines for the management of pain, agitation and delirium
in adult patients in the intensive care unit developed by a working group of the American College of Critical Care
Medicine (ACCCM) state that adult patients treated in the ICU routinely experience pain at rest and during routine
care. The guidelines recommend routine monitoring of pain in all adult patients in the ICU using the Behavioral
Pain Scale (BPS) or Critical-Care Pain Observation Tool (CPOT). Cultural adaptation was conducted in Poland,
psychometric properties of Polish version of Behavioral Pain Scale (BPS) were evaluated. Internal consistency
determined by Cronbach’s alpha amounted to 0.6883. The correlation coefficients between items of the scale and the
sum score in the pain phase were in the range 0.27-0.28. The analysis of principal components confirmed that all the
components of the scale respectively, the face, the upper limbs, synchronization with the respirator are one factor and
explain 63.9% of the rating variation, while discriminatory accuracy of the scale was unconfirmed. The value of pain
assessment using the Polish version of BPS increased significantly, also in the case of routine painless procedures,
most likely due to other factors. That prevented the unambiguous interpretation of the results of the pain assessment
and enforced additional data from other sources in the assessment of pain. The reason for the lack of discriminant
accuracy can be vague operationalization of the scale indicators especially in the category: Face and Synchronization
with the ventilator and the lack of adequate training for personnel in scale application. The aim of the study was to
prepare the Polish version of Behavioral Pain Scale (BPS) with more favorable psychometric properties. Based on the
analysis of the literature individual scale indicators included in the categories of Face and Synchronization with the
ventilator and the scheme of their scoring were re-defined. The result of the study is modified Polish version of BPS.
Conclusions: The validation process of the research tool is not a one-time process. The implementation of the scale
into clinical practice is required as well as further monitoring of its reliability and validity indicators. It is necessary to
implement the system of personnel training in BPS application
Behavioral Pain Scale and Critical Care Pain Observation Tool for pain evaluation
in orotracheally tubed critical patients. A systematic review of the literature