무의식 중환자의 비언어적 통증사정 도구의 신뢰도와 타당도 검증
Reliability and Validity of Nonverbal Pain Assessment Scale for Patients who Stayed a Intensive Care Units
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Patients unable to speak are at higher risk for untreated pain. Use of valid behavioral and physiologic measures for pain is highly recommended for uncommunicative patients. This study was performed to compare the reliability and validity of NVPS-K and CPOT-K for pain assessment of nonverbal patients. This study was conducted from July to November 2011. A total of 29 nonverbal adult patients admitted to a university hospital intensive care unit participated in this study. Interrater reliability of the NVPS-K and CPOT-K had intermediate to high intraclass correlation coefficients (NVPS-K 0.680 ～ 0.921, CPOT-K 0.710 ～ 0.896). Discriminant validity was supported with higher instrument scores during turning and endotracheal suctioning than that of NIBP. For criterion validity, the NVPS-K scores were correlated to the self-reported pain of the patients but not the CPOT-K scores. The areas under the ROC curve for the NVPS-K and CPOT-K were 0.748 and 0.696 with cutoff points of 1 and 2, respectively. Thus, the NVPS-K and CPOT-K had a sensitivity and specificity of 94.7% and 45.0%, and 60.5% and 75.0%, respectively. The NVPS-K and CPOT-K are reliable and valid tools to assess pain in nonverbal patient and thus, are recommended for the assessment of the pain in nonverbal patients.
Abstract
Patients unable to speak are at higher risk for untreated pain. Use of valid behavioral and physiologic measures for pain is highly recommended for uncommunicative patients. This study was performed to compare the reliability and validity of NVPS-K and CPOT-K for pain assessment of nonverbal patients. This study was conducted from July to November 2011. A total of 29 nonverbal adult patients admitted to a university hospital intensive care unit participated in this study. Interrater reliability of the NVPS-K and CPOT-K had intermediate to high intraclass correlation coefficients (NVPS-K 0.680 ～ 0.921, CPOT-K 0.710 ～ 0.896). Discriminant validity was supported with higher instrument scores during turning and endotracheal suctioning than that of NIBP. For criterion validity, the NVPS-K scores were correlated to the self-reported pain of the patients but not the CPOT-K scores. The areas under the ROC curve for the NVPS-K and CPOT-K were 0.748 and 0.696 with cutoff points of 1 and 2, respectively. Thus, the NVPS-K and CPOT-K had a sensitivity and specificity of 94.7% and 45.0%, and 60.5% and 75.0%, respectively. The NVPS-K and CPOT-K are reliable and valid tools to assess pain in nonverbal patient and thus, are recommended for the assessment of the pain in nonverbal patients.
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