Abstract
Introduction: Pain self-report is the gold standard of pain assessment. Mechanically ventilated patients cannot self-report the pain due to the presence of a tracheal tube and changes in the level of consciousness caused by sedation, exposing them to the risk of inadequate pain management that leads to psychological and physiological consequences. This study aimed to present a review of the published evidence and studies concerning the scales used in pain assessment in mechanically ventilated patients according to their psychometric characteristics and application in the nursing practice. Methods: We conducted a systematic review following PRISMA guidelines. National and international journals in such databases as Science Direct, PubMed, EMBASE, Pro Quest Central, Web of Science, SID, and Magiran were searched using Persian and English keywords, and retrieved articles were included in this review based on the inclusion and exclusion criteria. Results: 22 articles were included in this review based on the inclusion and exclusion criteria. According to the research objectives, findings were extracted from selected articles and reviewed in two sections: 1] validity and reliability, and 2] clinical application. Conclusion: Scales of CPOT and BPS are superior to NVPS, and a combination of BPS and CPOT improves the pain detection accuracy, and vital symptoms should be used cautiously for pain assessment along with objective measures due to poor evidence. Moreover, rapid and effective pain relief plays an important role in the improvement of psychological and physiological consequences.
Highlights
Pain self-report is the gold standard of pain assessment
Patients aged < 16 years undergoing mechanical ventilation, studies using other scales for pain assessment, gray literature, letters, editorials, commentaries, review articles, and those presented at seminars and conferences and Pain Behavior Assessment Tool (PBAT) tool this tool is not designed as a scoring tool, and pain management decisions are based on nurses' clinical judgment with this tool [12] were excluded from this review
Patients hospitalized in intensive care unit (ICU) usually suffer from mild to severe pain, and most of them are not able to self-report pain
Summary
Ventilated patients cannot self-report the pain due to the presence of a tracheal tube and changes in the level of consciousness caused by sedation, exposing them to the risk of inadequate pain management that leads to psychological and physiological consequences. Patient conditions and some factors in ICUs, including endotracheal intubation, mechanical ventilation, reduction of consciousness level, sedation, and administration of relaxing drugs, can change verbal communication and make pain assessment difficult [9]. Ventilated patients cannot self-report the pain due to the presence of tracheal tube and changes in the level of consciousness caused by sedation [5, 8], exposing them to the risk of inadequate pain. The first essential step in pain control is the assessment [7], that is, a reliable assessment tool is necessary for effective pain management. Behavioral Pain Scale (BPS), Critical Care Pain Observational Tool (CPOT), and Pain Behavior Assessment Tool (PBAT) are the most common one-dimensional scales, and Nonverbal Pain Scale (NVPS) and Pain Assessment and Intervention Notation (PAIN) Algorithm are the most widespread multi-dimensional scales [17]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
