Validation of The Critical-care Pain Observation Tool (CPOT) for the detection of oral-pharyngeal pain in critically ill adults

Authors

Craig M. Dale, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada; Sunnybrook Health Sciences Centre, Toronto, Canada. Electronic address: craig.dale@utoronto.ca.
Virginia Prendergast, Barrow Neurological Institute, Phoenix, AZ, United States.Follow
Céline Gélinas, Ingram School of Nursing, McGill University, Montréal, Canada; Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, CIUSSS Centre-Ouest-Ile-Montréal, Montréal, Canada.
Louise Rose, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.

Document Type

Article

Abstract

OBJECTIVE: Mechanically ventilated patients experience pain at rest and during daily care procedures. Our objective was to test the reliability and validity of the Critical-Care Pain Observation Tool (CPOT) to detect oral-pharyngeal pain in intubated and tracheostomised adults during routine oral care procedures. MATERIALS AND METHODS: Two trained research team members independently observed patients during two non-painful (rest and gentle touch) and three potentially painful (oral suctioning, tooth brushing, and swabbing with a sponge toothette) procedures. Conscious patients were asked if they experienced pain during each procedure (yes/no) and to rate their pain intensity on a 0 to 10 numeric rating scale. RESULTS: A total of 98 patients, primarily intubated (92.9%) and male (63.3%) participated. Criterion validation was supported by patient self-report of pain during tooth brushing (AUC=.80; P<0.5) and oral suction (AUC=.72; P<0.3) but not for oral swabbing (AUC=.68; P=0.16). Discriminative validation was demonstrated for all oral care procedures compared to rest (P<.001). Intra-class correlation coefficients between raters ranged from .78 to .91 (P<.001) for total CPOT scores, indicating excellent inter-rater reliability. CONCLUSIONS: The CPOT is reliable and valid for the detection of oral-pharyngeal pain during oral care procedures indicated as painful by critically ill adults.

Medical Subject Headings

Adult; Aged; Critical Care (methods); Critical Illness (psychology, therapy); Female; Humans; Male; Middle Aged; Oropharynx; Pain Management; Pain Measurement (methods); Pain, Procedural (diagnosis); Prospective Studies

Publication Date

12-1-2018

Publication Title

Journal of critical care

E-ISSN

1557-8615

Volume

48

First Page

334

Last Page

338

PubMed ID

30286403

Digital Object Identifier (DOI)

10.1016/j.jcrc.2018.09.024

Recommended Citation

Dale, Craig M.; Prendergast, Virginia; Gélinas, Céline; and Rose, Louise, "Validation of The Critical-care Pain Observation Tool (CPOT) for the detection of oral-pharyngeal pain in critically ill adults" (2018). Neuroscience Nursing. 19.
https://scholar.barrowneuro.org/neuroscience-nursing/19