PMID- 25829139
OWN - NLM
STAT- MEDLINE
DCOM- 20180416
LR  - 20220408
IS  - 1550-5049 (Electronic)
IS  - 0889-4655 (Linking)
VI  - 31
IP  - 5
DP  - 2016 Sep-Oct
TI  - Validation of the Critical-Care Pain Observation Tool and Vital Signs in Relation 
      to the Sensory and Affective Components of Pain During Mediastinal Tube Removal 
      in Postoperative Cardiac Surgery Intensive Care Unit Adults.
PG  - 425-32
LID - 10.1097/JCN.0000000000000250 [doi]
AB  - BACKGROUND: The Critical-Care Pain Observation Tool (CPOT) is a behavioral scale 
      recommended in clinical practice guidelines for the assessment of pain in 
      nonverbal intensive care unit (ICU) adults. Although the CPOT has been validated 
      in various ICU patient groups, its association with the affective component of 
      pain has not yet been explored, and in most studies, turning was the used 
      nociceptive procedure. AIM: In this study, we aim to validate the use of the CPOT 
      and vital signs in association with the sensory and affective components of pain 
      during mediastinal tube removal (MTR) in postoperative cardiac surgery ICU 
      adults. METHODS: A sample of 125 patients participated in this prospective 
      repeated-measures, within-subject study. A total of 6 assessments of the main 
      study variables (CPOT scores and patients' self-reports of pain intensity and 
      unpleasantness) were completed by trained research assistants while patients were 
      in the ICU. Assessments were done before, during, and 15 minutes after the 
      nonnociceptive procedure (ie, noninvasive blood pressure taking [NIBP]) and 
      nociceptive procedure (ie, MTR). RESULTS: Discriminant validation of the scale 
      use was supported as higher CPOT scores were obtained during MTR (mean [SD], 2.74 
      [1.61]) compared with NIBP (mean [SD], 0.50 [0.747]) (t124 = 14.33, P < .001). 
      Similarly, higher values were recorded for mean arterial pressure and heart and 
      respiratory rates during MTR compared with NIBP (P < .01). During MTR, CPOT 
      scores correlated significantly with self-report of pain intensity (r = 0.419, P 
      < .01) and unpleasantness (r = 0.313, P < .01), supporting criterion and 
      convergent validation. Conversely, vital signs did not correlate with either 
      self-report. CONCLUSIONS: Study findings confirmed the validity of the CPOT for 
      the assessment of the sensory and affective components of pain in the postcardiac 
      surgery ICU adults. Vital signs were not specific to pain and should be used only 
      as cues to begin further assessment of pain using validated instruments for this 
      purpose.
FAU - Boitor, Madalina
AU  - Boitor M
AD  - Madalina Boitor, RN, BSc(N) PhD Student, Ingram School of Nursing, McGill 
      University, Montreal, Quebec, Canada. Jacinthe Lachance Fiola, PhD Psychologist, 
      Universite du Quebec a Montreal, Quebec, Canada. Celine Gelinas, PhD, RN 
      Associate Professor, Ingram School of Nursing, McGill University; Researcher and 
      Project Director, Centre for Nursing Research and Lady Davis Institute, Jewish 
      General Hospital; Co-Leader of the Research Axis on Personalized Care, Quebec 
      Nursing Interventions Research Network (RRISIQ); and Member of Alan Edwards 
      Centre for Research on Pain, McGill University, Montreal, Quebec, Canada.
FAU - Fiola, Jacinthe Lachance
AU  - Fiola JL
FAU - Gelinas, Celine
AU  - Gelinas C
LA  - eng
PT  - Journal Article
PT  - Validation Study
PL  - United States
TA  - J Cardiovasc Nurs
JT  - The Journal of cardiovascular nursing
JID - 8703516
SB  - IM
MH  - Adult
MH  - *Cardiovascular Surgical Procedures
MH  - *Critical Care
MH  - Humans
MH  - Intensive Care Units
MH  - Pain
MH  - *Pain Measurement
MH  - Postoperative Care
MH  - Prospective Studies
EDAT- 2015/04/02 06:00
MHDA- 2018/04/17 06:00
CRDT- 2015/04/02 06:00
PHST- 2015/04/02 06:00 [entrez]
PHST- 2015/04/02 06:00 [pubmed]
PHST- 2018/04/17 06:00 [medline]
AID - 10.1097/JCN.0000000000000250 [doi]
PST - ppublish
SO  - J Cardiovasc Nurs. 2016 Sep-Oct;31(5):425-32. doi: 10.1097/JCN.0000000000000250.