Research On The Application Of Chinese Version Of The Revised Adult Nonverbal Pain Scale In Evaluating Of The Critical Ill Patients

BackgroundPain is a common and distressing experience for ICU patients. However, it is difficult to assess because the critically ill patients are often unable to communicate verbally due to the use of endotracheal/tracheostomy tubes and sedative agents. Previous studies have demonstrated that some of Pain Observation Tools are valid evaluation tool in critical care. However, Our country is still at its early stage in pain assessment of critically ill patients. It is necessary to choose a pain assessment tool with adequate reliability, validity and found a suitable pain assessment system. Regular use of pain assessment tools can free patients from the painful state of excessive sedation and insufficient analgesia so as to improve patients’ compliance and make them cooperate actively through the treatment.ObjectiveTo translate the Revised Adult Nonverbal Pain Scale into Chinese and examine the reliability,validity and compare the Predictive Power of the Revised Adult Nonverbal Pain Scale with BPS and CPOT.MethodsA four-stepped process was adapted to develop the Chinese version of the Revised Adult Nonverbal Pain Scale. To establish the scale’s validity and reliability, Internal consistency reliability analysis, Inter-rater reliability analysis, factor analysis, correlation analysis, prediction validity analysis, sensitivity and specificity analysis were undertaken.ResultsThe scale includes5items:(1) Face,(2) Activity(movement),(3) Guarding,(4) Physiology(vital signs), and (5) Respiratory. Its internal consistency reliability is high (Cronbach’s a=0.802), Inter-rater reliability ICC=0.809-0.974and correlation analysis r=0.665-0.835(P<0.05). Constructive validity and related validity are fine. There is significant difference between Painful stimuli and Non-painful stimuli (t=-42.825, P<0.05). The optimal cut-off point of the NVPS-R in our study was3. There is no significant difference in BPS, CPOT and NVPS-R. ConclusionsThe Chinese version of the Revised Adult Nonverbal Pain Scale is a valid and reliable disease-specific instrument in critically ill patients.