COSMIN database

Pain assessment tools for unconscious or sedated intensive care patients: a systematic review

Authors:
Pudas-Tahka, S. M., Axelin, A., Aantaa, R., Lund, V., and Salantera, S.
Abstract:
AIM: This paper is a report of a systematic review describing instruments developed for pain assessment in unconscious or sedated intensive care patients.

BACKGROUND: Intensive care patients who are unconscious or sedated are unable to communicate and therefore recognition and assessment of the pain is difficult. To assess these patients' pain, it is important to use a valid and reliable pain assessment tool.

DATA SOURCES: A systematic bibliographical review was conducted, based on seven databases, covering the period from January 1987 to February 2007. A total of 1,586 abstracts was identified and reviewed, 58 papers were selected for full-text review and nine papers were included in the review.

METHODS: Two researchers independently reviewed the abstracts and three reviewers extracted the papers. The included papers were evaluated using a quality assessment instrument previously developed to evaluate pain assessment tools.

RESULTS: Five different pain assessment tools were identified that had been used with unconscious or sedated intensive care patients. All five instruments included behavioural indicators and three included physiological indicators. Their psychometric properties varied and it was not possible to deduce their clinical utility.

CONCLUSION: All instruments were reasonably new. In most of them psychometric testing was in an early stage or even absent. Before any of the reported instruments can be chosen in preference to others, it is essential to test their validity, reliability and feasibility further.
DOI:
10.1111/j.1365-2648.2008.04947.x
URL:
https://www.ncbi.nlm.nih.gov/pubmed/19291192
Journal:
J Adv Nurs
issn:
1365-2648 (Electronic)
Publication year:
2009
pages:
946-56
Symptom status:
Physical state
Age:
Adults (18-65)
Seniors (65+)
Disease:
Certain conditions originating in the perinatal period and related symptoms
Certain infections and parasitic diseases and related symptoms
Congenital malformations, deformations and chromosomal abnormalities and related symptoms
Diseases of and symptoms related to the blood and blood-forming organs and certain disorders involving the immune mechanism
Diseases of and symptoms related to the circulatory system
Diseases of and symptoms related to the digestive system
Diseases of and symptoms related to the ear and mastoid process
Diseases of and symptoms related to the eye and adnexa
Diseases of and symptoms related to the genitourinary system
Diseases of and symptoms related to the musculoskeletal system and connective tissue
Diseases of and symptoms related to the nervous system
Diseases of and symptoms related to the respiratory system
Diseases of and symptoms related to the skin and subcutaneous tissue
Endocrine, nutritional and metabolic diseases and related symptoms
External causes of morbidity and mortality
Injury, poisoning and certain other consequences of external causes
Mental and behavioural disorders and related symptoms
Neoplasms and related symptoms
Pregnancy, childbirth and puerperium and related symptom
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
6 - Clinical rating scales
7 - Observations
9 - Laboratory tests
Instrument:
BPS - Behavioural Pain Scale
CPOT - Critical-Care Pain Observation Tool
NVPS - Nonverbal Pain Scale
Pain Assessment Algorithm
P.A.I.N. - Pain Assessment and Intervention Notation Algorithm