Assessing pain in non-intubated critically ill patients unable to self report: an adaptation of the Behavioral Pain Scale

Purpose To validate an adaptation of the Behavioral Pain Scale (BPS) for its use in non-intubated intensive care unit (ICU) patients unable to self-report their pain because of the occurrence of delirium. The “vocalization” domain was inserted to construct the BPS-non intubated (BPS-NI) scale, rangi...

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Bibliographic Details
Published in:Intensive care medicine 2009-12, Vol.35 (12), p.2060-2067, Article 2060
Main Authors: Chanques, Gérald, Payen, Jean-François, Mercier, Grégoire, de Lattre, Sylvie, Viel, Eric, Jung, Boris, Cissé, Moussa, Lefrant, Jean-Yves, Jaber, Samir
Format: Article
Language:English
Subjects:
Adaptation
Aged
Analgesics
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthesiology
Behavior
Biological and medical sciences
Compliance
Critical care
Critical Care - standards
Critical Care Medicine
Critical Illness
Delirium
Emergency Medicine
Facial Expression
Female
Humans
Intensive
Intensive care
Intensive care medicine
Intensive Care Units - statistics & numerical data
Intubation - statistics & numerical data
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Movement
Neuropharmacology
Original
Pain
Pain - diagnosis
Pain - epidemiology
Pain Measurement
Pain Medicine
Patients
Pediatrics
Pharmacology. Drug treatments
Pneumology/Respiratory System
Quantitative psychology
Reproducibility of Results
Self Efficacy
Severity of Illness Index
Surveys and Questionnaires
Upper Extremity
Ventilators
Verbal Behavior
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Summary:Purpose To validate an adaptation of the Behavioral Pain Scale (BPS) for its use in non-intubated intensive care unit (ICU) patients unable to self-report their pain because of the occurrence of delirium. The “vocalization” domain was inserted to construct the BPS-non intubated (BPS-NI) scale, ranging from 3 (no pain) to 12 (most pain). Design Prospective psychometric study in a medical-surgical ICU. Methods The same physician and one bedside nurse rated pain in non-intubated patients unable to self-report their pain during four conditions: before and after a catheter dressing change (non-nociceptive procedure) and before and after turning the patient (nociceptive procedure). Delirium was assessed by the Confusion Assessment Method for the ICU (CAM-ICU). Results A total of 120 paired evaluations were performed in 30 consecutive adult patients, 84% with delirium (CAM-ICU positive). BPS-NI scores were higher during painful procedures than at rest [6.0 (5.0–8.0) vs. 3.0 (3.0–3.8); P  
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-009-1590-5