The validation of C-POT (Critical-Care Pain Observation Tool) scale: a tool for assessing pain in intensive care patients

Abstract

Pain in intensive care units is a frequent and often undermanaged problem, mainly because appropriate pain assessment tools for non communicative patients are still missing. The Critical-Care Pain Observation Tool (C-POT) is currently considered one of the best scales, both for psychometric properties and clinical feasibility. To preliminarily analyze the reliability and validity of the C-POT in a hospital setting, and its clinical feasibility. 50 nursing staff members from three different critical care settings of Vicenza Hospital administered the C-POT to 121 in patients, at rest and after usual nursing care activities. In addition, NOPPAIN forms were completed during care activities and communicative patients were asked to rate their pain using numerical rating scale 0-10. Reliability, with Cronbach's alfa and inter-rater agreement (Spearman's non parametric rank correlation), as well as criterion, concurrent and discriminant validity were determined. A good internal consistency and good levels of agreement between independent raters were observed (ρSpearman 0.55 at rest and 0.66 during activity). Moderate correlations between C-POT and numerical rating scale 0-10, and between C-POT and NOPPAIN were found. Moreover, C-POT scores varied from rest to activities, and from non painful to painful procedures. C-POT showed good psychometric properties in terms of reliability and validity; these results, added to positive nurses evaluations, support its utility and use in the clinical setting.