Pain assessment tools in critical patients with oral communication difficulties: a scope review

Camila Kaory Kawagoe,Marina De Góes Salvetti,Jessica Yumi Matuoka

doi:10.5935/1806-0013.20170032

Abstract

ABSTRACT BACKGROUND AND OBJECTIVES: Pain is a frequent experience in intensive care units and its assessment and handling are challenging to healthcare professionals. The objective of this study was to identify and analyze the available tools to assess pain in patients with oral communication difficulties in intensive care units. CONTENTS: Scope review of the literature in six databases that identified four observational tools to assess pain in critical patients: Behavioral Pain Scale, Critical-Care Pain Observation Tool, Nociception Coma Scale and Nociception Coma Scale-Revised. All tools use behavior indicators of pain and only one is adapted to the Portuguese language. CONCLUSION: The use of a valid, easy to apply instrument, with clear and straightforward descriptions is essential to assess pain in patients with oral communication difficulties in intensive care units. There are good quality tools to assess pain in intensive care units. Most tools, however, are not yet validated to the Portuguese language. Translation and validation studies are necessary so that tools with well-established psychometric properties can be available in our practice.

Highlights

In the intensive care unit environment (ICU), patients are subjected to several procedures that can be painful, and not always healthcare professionals are alert to pain in these patients[1,2]
Physiological indicators such as heart rate, blood pressure, and the respiratory rate could be used in pain assessment, but they are nonspecific elements in critical patients since they are vulnerable to multiple factors, including the effect of the drugs used in ICU4,9
Considering the lack of tools validated for the Portuguese language to assess pain in critical patients, the objective of this study was to identify and analyze the available tools to assess pain in patients with oral communication difficulty in the ICU

Summary

INTRODUCTION

In the intensive care unit environment (ICU), patients are subjected to several procedures that can be painful, and not always healthcare professionals are alert to pain in these patients[1,2]. Several scales based on behavior indicators of pain are being applied to assess and register this symptom in critical patients[4,5,6,7,8] being considered important tools to assess pain in patients incapable of communicating[5]. Considering the lack of tools validated for the Portuguese language to assess pain in critical patients, the objective of this study was to identify and analyze the available tools to assess pain in patients with oral communication difficulty in the ICU. Nociception Coma Scale-Revised (NCS-R) Revised version of the NCS, with the exclusion of the visual response domain It was developed for pain assessment in patients with disorders of consciousness, consisting of 3 subscales that evaluate motor, oral and facial expression responses. The self-report of pain in conscious patients was considered by them the “gold standard” in pain asses-

Key Features

Findings

CONCLUSION