Validation of critical care pain observation tool in patients hospitalized in surgical wards

Malihe Rafiei, Ahmad Ghadami, Alireza Irajpour, Avat Feizi



Background: Application of a reliable and authentic behavioral tool for measuring patients’ pain, hospitalized in intensive care
units who are not able to establish relationship, is needed severely. Therefore, this study is conducted with the aim of validating
Critical Care Pain Observation Tool (CPOT) in patients hospitalized in surgical wards.
Materials and Methods: CPOT was first translated into Persian and was psychometrically measured in terms of content.
Then, this study was conducted as cross-sectional study on 60 patients who were hospitalized in surgical wards. The degree of
pain was measured by the patients using a self-report pain tool (NRS) and with the help of two nurses using CPOT during two
painful and nonpainful procedures. Eventually, diagnosed validity and reliability was studied.
Results: It should be noted that the content validity of CPOT was approved by panel of specialists. In addition, validity of this tool was confirmed with high internal cluster correlation (nonpainful procedure (0.997) and painful procedure (0.726). The diagnostic validity was supported with the increased CPOT score during position change and its constancy during the measurement of blood pressure (P < 0.001). Despite higher NRS scores than CPOT, CPOT criterion validity was confirmed due to the correlation between the scores obtained by these two tools (P < 0.001).
Conclusions: CPOT is a valid and reliable tool to study pain in patients hospitalized in intensive care units.


Critical care; pain assessment; validity

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