title: Pain assessment using the critical-care pain observation tool in Chinese critically ill ventilated adults.
abstract: BACKGROUND
  The psychometric properties of the Critical-Care Pain Observation Tool (CPOT) need to be tested in general intensive care unit patient populations in China.
  
  
  OBJECTIVE
  To further evaluate the psychometric properties of the CPOT and provide a pain assessment method for Chinese critically ill ventilated adults by validating a translation of the CPOT.
  
  
  METHODS
  A total of 63 conscious ventilated Chinese adults were repeatedly assessed by two independent raters using the CPOT at rest as well as before and during the two procedures: 1) nociceptive procedure (turning) and 2) non-nociceptive procedure (taking noninvasive blood pressure). A total of 12 assessments were included.
  
  
  RESULTS
  The principal component factor analysis revealed that the domain structure of the CPOT was acceptable. Cronbach's α coefficient as a measure for the internal consistency ranged from 0.57 to 0.86; intraclass correlation coefficients as a measure for inter-rater reliability ranged from 0.80 to 0.91; Spearman nonparametric coefficients as a measure for test-retest reliability ranged from 0.81 to 0.93. The CPOT total score was significantly higher during the nociceptive procedure, indicating that its discriminant validity was good. Self-reported pain was obtained as the gold standard; the receiver operating characteristic curve analysis determined the best cutoff value of the CPOT (>2) with the specificity (73.3-81.8%) and sensitivity (80.8-89.4%) as well as the area under the curve (range 0.849-0.902).
  
  
  CONCLUSIONS
  The CPOT has good psychometric properties and can be used as a reliable and valid instrument for pain assessment in Chinese critically ill ventilated adults.
authors.affiliation: Department of Critical Care MedicineThe First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China; Critical Care Medical Research Institute, Dalian Medical University, Dalian, People's Republic of China. Electronic address: liqingdong2@163.com.
authors.forename: Qingdong
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Critical Care MedicineThe First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China; Critical Care Medical Research Institute, Dalian Medical University, Dalian, People's Republic of China.
authors.forename: Xianyao
authors.initials: X
authors.lastname: Wan
authors.affiliation: Department of Critical Care MedicineThe First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China; Nursing Department, The First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
authors.forename: Chunmei
authors.initials: C
authors.lastname: Gu
authors.affiliation: Department of English Education, Dalian Medical University, Dalian, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Critical Care MedicineThe First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China; Critical Care Medical Research Institute, Dalian Medical University, Dalian, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Critical Care MedicineThe First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China; Critical Care Medical Research Institute, Dalian Medical University, Dalian, People's Republic of China.
authors.forename: Suwei
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Critical Care MedicineThe First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China; Critical Care Medical Research Institute, Dalian Medical University, Dalian, People's Republic of China.
authors.forename: Yongli
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D019540:Area Under Curve; D002681:China; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007802:Language; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D025341:Principal Component Analysis; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results; D012121:Respiration, Artificial; D057566:Self Report; D012680:Sensitivity and Specificity
keywords: Pain assessment; critical care; intensive care unit; psychometrics; ventilation