The Behavior Pain Assessment Tool for critically ill adults: a validation study in 28 countries.
Identifieur interne : 000B10 ( Main/Exploration ); précédent : 000B09; suivant : 000B11The Behavior Pain Assessment Tool for critically ill adults: a validation study in 28 countries.
Auteurs : Céline Gélinas [Canada] ; Kathleen A. Puntillo [États-Unis] ; Pavel Levin [Canada] ; Elie Azoulay [France]Source :
- Pain [ 1872-6623 ] ; 2017.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Autorapport (MeSH), Coopération internationale (MeSH), Douleur (diagnostic), Douleur (psychologie), Femelle (MeSH), Humains (MeSH), Maladie grave (psychologie), Maladie grave (épidémiologie), Mesure de la douleur (MeSH), Mâle (MeSH), Psychométrie (MeSH), Reproductibilité des résultats (MeSH).
- MESH :
- diagnostic : Douleur.
- psychologie : Douleur, Maladie grave.
- épidémiologie : Maladie grave.
- Adulte, Autorapport, Coopération internationale, Femelle, Humains, Mesure de la douleur, Mâle, Psychométrie, Reproductibilité des résultats.
English descriptors
- KwdEn :
- MESH :
- diagnosis : Pain.
- epidemiology : Critical Illness.
- psychology : Critical Illness, Pain.
- Adult, Female, Humans, International Cooperation, Male, Pain Measurement, Psychometrics, Reproducibility of Results, Self Report.
Abstract
Many critically ill adults are unable to communicate their pain through self-report. The study purpose was to validate the use of the 8-item Behavior Pain Assessment Tool (BPAT) in patients hospitalized in 192 intensive care units from 28 countries. A total of 4812 procedures in 3851 patients were included in data analysis. Patients were assessed with the BPAT before and during procedures by 2 different raters (mostly nurses and physicians). Those who were able to self-report were asked to rate their pain intensity and pain distress on 0 to 10 numeric rating scales. Interrater reliability of behavioral observations was supported by moderate (0.43-0.60) to excellent (>0.60) kappa coefficients. Mixed effects multilevel logistic regression models showed that most behaviors were more likely to be present during the procedure than before and in less sedated patients, demonstrating discriminant validation of the tool use. Regarding criterion validation, moderate positive correlations were found during procedures between the mean BPAT scores and the mean pain intensity (r = 0.54) and pain distress (r = 0.49) scores (P < 0.001). Regression models showed that all behaviors were significant predictors of pain intensity and pain distress, accounting for 35% and 29% of their total variance, respectively. A BPAT cut-point score >3.5 could classify patients with or without severe levels (≥8) of pain intensity and distress with sensitivity and specificity findings ranging from 61.8% to 75.1%. The BPAT was found to be reliable and valid. Its feasibility for use in practice and the effect of its clinical implementation on patient pain and intensive care unit outcomes need further research.
DOI: 10.1097/j.pain.0000000000000834
PubMed: 28362678
Affiliations:
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The study purpose was to validate the use of the 8-item Behavior Pain Assessment Tool (BPAT) in patients hospitalized in 192 intensive care units from 28 countries. A total of 4812 procedures in 3851 patients were included in data analysis. Patients were assessed with the BPAT before and during procedures by 2 different raters (mostly nurses and physicians). Those who were able to self-report were asked to rate their pain intensity and pain distress on 0 to 10 numeric rating scales. Interrater reliability of behavioral observations was supported by moderate (0.43-0.60) to excellent (>0.60) kappa coefficients. Mixed effects multilevel logistic regression models showed that most behaviors were more likely to be present during the procedure than before and in less sedated patients, demonstrating discriminant validation of the tool use. Regarding criterion validation, moderate positive correlations were found during procedures between the mean BPAT scores and the mean pain intensity (r = 0.54) and pain distress (r = 0.49) scores (P < 0.001). Regression models showed that all behaviors were significant predictors of pain intensity and pain distress, accounting for 35% and 29% of their total variance, respectively. A BPAT cut-point score >3.5 could classify patients with or without severe levels (≥8) of pain intensity and distress with sensitivity and specificity findings ranging from 61.8% to 75.1%. The BPAT was found to be reliable and valid. Its feasibility for use in practice and the effect of its clinical implementation on patient pain and intensive care unit outcomes need further research.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28362678</PMID><DateCompleted><Year>2017</Year><Month>04</Month><Day>25</Day></DateCompleted><DateRevised><Year>2021</Year><Month>01</Month><Day>13</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1872-6623</ISSN><JournalIssue CitedMedium="Internet"><Volume>158</Volume><Issue>5</Issue><PubDate><Year>2017</Year><Month>05</Month></PubDate></JournalIssue><Title>Pain</Title><ISOAbbreviation>Pain</ISOAbbreviation></Journal><ArticleTitle>The Behavior Pain Assessment Tool for critically ill adults: a validation study in 28 countries.</ArticleTitle><Pagination><MedlinePgn>811-821</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/j.pain.0000000000000834</ELocationID><Abstract><AbstractText>Many critically ill adults are unable to communicate their pain through self-report. The study purpose was to validate the use of the 8-item Behavior Pain Assessment Tool (BPAT) in patients hospitalized in 192 intensive care units from 28 countries. A total of 4812 procedures in 3851 patients were included in data analysis. Patients were assessed with the BPAT before and during procedures by 2 different raters (mostly nurses and physicians). Those who were able to self-report were asked to rate their pain intensity and pain distress on 0 to 10 numeric rating scales. Interrater reliability of behavioral observations was supported by moderate (0.43-0.60) to excellent (>0.60) kappa coefficients. Mixed effects multilevel logistic regression models showed that most behaviors were more likely to be present during the procedure than before and in less sedated patients, demonstrating discriminant validation of the tool use. Regarding criterion validation, moderate positive correlations were found during procedures between the mean BPAT scores and the mean pain intensity (r = 0.54) and pain distress (r = 0.49) scores (P < 0.001). Regression models showed that all behaviors were significant predictors of pain intensity and pain distress, accounting for 35% and 29% of their total variance, respectively. A BPAT cut-point score >3.5 could classify patients with or without severe levels (≥8) of pain intensity and distress with sensitivity and specificity findings ranging from 61.8% to 75.1%. The BPAT was found to be reliable and valid. Its feasibility for use in practice and the effect of its clinical implementation on patient pain and intensive care unit outcomes need further research.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Gélinas</LastName><ForeName>Céline</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Ingram School of Nursing, Faculty of Medicine, McGill University, Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Puntillo</LastName><ForeName>Kathleen A</ForeName><Initials>KA</Initials><AffiliationInfo><Affiliation>School of Nursing, Department of Physiological Nursing, University of California San Francisco (UCSF), San Francisco, CA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Levin</LastName><ForeName>Pavel</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Azoulay</LastName><ForeName>Elie</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Medical Intensive Care Unit, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis, Université Paris-Diderot, Paris, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Pain</MedlineTA><NlmUniqueID>7508686</NlmUniqueID><ISSNLinking>0304-3959</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016638" MajorTopicYN="N">Critical Illness</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007391" MajorTopicYN="Y">International Cooperation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010146" MajorTopicYN="N">Pain</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010147" MajorTopicYN="Y">Pain Measurement</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011594" MajorTopicYN="Y">Psychometrics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015203" MajorTopicYN="N">Reproducibility of Results</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D057566" MajorTopicYN="N">Self Report</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>4</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>4</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>4</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28362678</ArticleId><ArticleId IdType="doi">10.1097/j.pain.0000000000000834</ArticleId><ArticleId IdType="pii">00006396-201705000-00008</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Ahlers SJGM, van der Veen AM, van Dijk M, Tibboel D, Knibbe CAJ. 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Clin Chem 1993;39:561–77.</Citation></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Canada</li><li>France</li><li>États-Unis</li></country><region><li>Californie</li><li>Québec</li><li>Île-de-France</li></region><settlement><li>Montréal</li><li>Paris</li></settlement><orgName><li>Université McGill</li></orgName></list><tree><country name="Canada"><region name="Québec"><name sortKey="Gelinas, Celine" sort="Gelinas, Celine" uniqKey="Gelinas C" first="Céline" last="Gélinas">Céline Gélinas</name></region><name sortKey="Levin, Pavel" sort="Levin, Pavel" uniqKey="Levin P" first="Pavel" last="Levin">Pavel Levin</name></country><country name="États-Unis"><region name="Californie"><name sortKey="Puntillo, Kathleen A" sort="Puntillo, Kathleen A" uniqKey="Puntillo K" first="Kathleen A" last="Puntillo">Kathleen A. Puntillo</name></region></country><country name="France"><region name="Île-de-France"><name sortKey="Azoulay, Elie" sort="Azoulay, Elie" uniqKey="Azoulay E" first="Elie" last="Azoulay">Elie Azoulay</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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