Validation of the use of the Critical-Care Pain Observation Tool (CPOT) with brain surgery patients in the neurosurgical intensive care unit.
Many critically ill patients are unable to self-report their pain. In such situations, the use of valid behavioral pain scales is recommended.


OBJECTIVE
To validate the use of the Critical-Care Pain Observation Tool (CPOT) with brain surgery adults in the neurosurgical intensive care unit.


METHODS
Repeated-measure within subject prospective design.


METHODS
Forty-three elective brain surgery patients of a Canadian university hospital participated.


METHODS
Participants were video recorded and scored with the CPOT before, during and after a non-nociceptive (non-invasive blood pressure using cuff inflation) and a nociceptive (turning) procedure for a total of six assessments. Self-reports of pain were also obtained.


RESULTS
Discriminant validation was supported with higher mean CPOT scores during the nociceptive procedure compared with the non-nociceptive one. More participants reported higher pain intensity during turning compared with cuff inflation. Criterion validation was supported with a moderate positive correlation between self-reports of pain intensity and CPOT scores during turning. Interrater and intrarater reliability of CPOT scores through the viewing of participants' videos by two trained raters was supported with high Intraclass Correlation Coefficients.


CONCLUSIONS
The CPOT appears to be valid for the detection of pain in elective brain surgery patients in the neurosurgical intensive care unit.
McGill University, Ingram School of Nursing, Montréal, Québec, Canada; Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montréal, Québec, Canada; McGill University Health Centre (MUHC), Montréal, Québec, Canada.
Christine
C
Echegaray-Benites
McGill University, Ingram School of Nursing, Montréal, Québec, Canada; Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montréal, Québec, Canada; McGill University Health Centre (MUHC), Montréal, Québec, Canada.
Oxana
O
Kapoustina
McGill University, Ingram School of Nursing, Montréal, Québec, Canada; Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montréal, Québec, Canada; Quebec Nursing Intervention Research Network (RRISIQ), Montréal, Québec, Canada; Alan Edwards Centre for Research on Pain, McGill University, Montréal, Québec, Canada. Electronic address: celine.gelinas@mcgill.ca.
Céline
C
Gélinas
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000067289:Behavior Observation Techniques / Q000379:methods*; D001921:Brain / Q000601:surgery*; D002170:Canada; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000451:nursing*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000451:nursing*; D010146:Pain / Q000175:diagnosis*; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results
Adult; Behavioral scale; Brain surgery; CPOT; Intensive care unit; Pain assessment