Family Members’ Experiences with Observing Pain Behaviors Using the Critical-Care Pain Observation Tool

Abstract

BackgroundCurrent guidelines support family members' participation in care, but little is known regarding their potential contribution to pain assessment using validated behavioral pain scales. AimsThis study aimed to describe family members’ observations of pain behaviors with the Critical-Care Pain Observation Tool and their evaluation of the tool and its use, and to understand their experience and perceptions of their potential role in pain management in the intensive care unit. DesignA mixed methods cross-sectional explanatory design was used. SettingA medical-surgical intensive care unit in Canada. Participants/SubjectsFamily members were eligible if they had a loved one admitted in the intensive care unit who was unable to self-report. MethodsFamily members identified pain behaviors using the Critical-Care Pain Observation Tool after a brief training, completed a self-administered questionnaire, and participated in a follow-up individual interview regarding their experience and perceived potential role in pain management when their loved one is unable to self-report. ResultsTen family members participated. A 15-minute training appeared sufficient for family members to be comfortable with observing pain behaviors included in the Critical-Care Pain Observation Tool. The tool allowed them to confirm their observations of pain behaviors, to focus more on the patient, and to advocate for better pain management. ConclusionsFuture research is needed to explore the views of more family members and to compare their Critical-Care Pain Observation Tool scores to the ones of nurses' for interrater reliability testing.