title: A preliminary validation of the Swedish version of the Critical-Care Pain Observation Tool in adults.
abstract: BACKGROUND
  Assessing pain in critically ill patients can be complicated, especially for those unable to communicate. A recently developed pain assessment tool, the Critical-Care Pain Observation Tool (CPOT), has been shown to be a reliable tool for pain assessment in the Intensive Care Unit (ICU). The aim of the study was to validate the Swedish version of the CPOT.
  
  
  METHODS
  Conscious and unconscious adults were observed during two procedures: one non-nociceptive procedure (NNP) (arm- and face wash) and one nociceptive procedure (NP) (turning). In total, there were 240 patient assessments pre-, per- and post-procedure performed by two independent staff members at rest, during and 15 min after the different procedures. Measures of interrater reliability, internal consistency and discriminant validity of the CPOT were obtained to examine the properties of the Swedish version of CPOT.
  
  
  RESULTS
  The results provide indications of good agreement between the independent raters (ICC=0.84). There was an adequate discriminant validity of the Swedish version of CPOT established by a significant peak for CPOT scores during the NP (per-procedure). There was also a consistent pattern of significant correlations between CPOT and the mean artery pressure (ρ=0.32-0.45).
  
  
  CONCLUSIONS
  The Swedish version of the CPOT is a suitable instrument for assessing pain in critically ill adults. The overall reliability and validity measures converge with findings from previous studies of the CPOT, but in order to achieve enhanced generalizability of the CPOT, we encourage further evaluation of CPOT in broader groups of critically ill patients.
authors.affiliation: Institution of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Nürnberg Damström
authors.forename: F
authors.initials: F
authors.lastname: Saboonchi
authors.forename: P V
authors.initials: PV
authors.lastname: Sackey
authors.forename: G
authors.initials: G
authors.lastname: Björling
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D016292:Procedural Sedation; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D009726:Nurses; D015588:Observer Variation; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold; D015203:Reproducibility of Results; D013548:Sweden
chemical_list: D000700:Analgesics