Acute pain evaluation with Algoplus scale in Cambodian patients.
OBJECTIVE
Evaluation of acute pain in patients with language barriers is often difficult during humanitarian missions. Algoplus, a behavioral scale validated for acute pain evaluation in Caucasians with verbal communication difficulties, was tested during a clinical mission in Cambodia in patients admitted to hospital for acute pain.


METHODS
Patients (N = 33, 19 men and 14 women [38 ± 3 years old]) suffering from acute pain were admitted to Calmette Hospital, Phnom Penh, Cambodia during June 2010. Patients spoke Khmer only; a medical trainee who did no speak Khmer performed the Algoplus scale, and a bilingual Khmer pain specialist doctor asked the patient to score pain intensity on a numerical scale (0-10). The relevance of the scale and of each item (facial expression, complaints, look, body position, and atypical behavior yes/no) was studied. Internal consistency was assessed by Cronbach alpha analysis and convergent validity by correlation coefficient. The relationship between Algoplus items and pain intensity was analysed.


RESULTS
Pain intensity (6.3 ± 2.2) and Algoplus scores (2.1 ± 1.2) are correlated (r = 0.61, P < 0.001): increases in Algoplus are correlated to increases in pain intensity. Internal consistency is 0.51, and scales comparison per item is significant for facial expression (P = 0.028) and complaints (P = 0.005), but not for the other items.


CONCLUSIONS
This feasibility study shows that despite a correlation with pain intensity, Algoplus may underestimate acute pain in this population. It is, however, an interesting tool for future studies to explore facial expression and complaints as proxies of pain in non-communicative patients.
The Non-Governmental Organisation "Pain without frontiers", Phnom Penh, Cambodia; Hospices Civils, Lyon, France.
Marie-Eva
ME
Pickering
Pal
P
Bunna
Patrice
P
Rat
Guylène
G
Madeline
Céline
C
Lebost
Alain
A
Serrie
Bruno
B
Pereira
D059787:Acute Pain / Q000175:diagnosis*; D000328:Adult; D044466:Asian People; D002160:Cambodia; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D010147:Pain Measurement / Q000379:methods*; D011594:Psychometrics
Algoplus®; Asians; Behavioral Scale; Noncommunicative