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疼痛量表行为学指标在外伤性脑损伤患者中的应用
Author(s) -
LópezLópez Candelas,
ArranzEsteban Antonio,
AriasRivera Susana,
SolísMuñoz Montserrat,
PérezPérez Teresa,
LatorreMarco Ignacio
Publication year - 2020
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.14400
Subject(s) - medicine , traumatic brain injury , sedation , observational study , physical therapy , pain scale , level of consciousness , intensive care unit , anesthesia , intensive care medicine , psychiatry
Aim To develop and psychometrically test the Behavioural Indicators of Pain Scale (ESCID) in patients with traumatic brain injury (TBI). Design A prospective observational study to test the psychometric properties of the Behavioural Indicators of Pain Scale in patients with TBI. Method A convenience sample of patients with TBI, who were non‐communicative and using invasive mechanical ventilation was selected. Pain was evaluated by two observers who were blinded from each other. Assessments were performed at baseline via the performance of a painful procedure (aspiration of secretions) and a non‐painful procedure (rubbing with a gauze). Assessments were repeated after application of procedures on days 1 and 6 of hospitalization in an intensive care unit. Data were collected between January–December 2016. Results About 134 patients were included in the study. Of these, 76.1% were men. The mean age of participants was 45.2 ( SD 17.5) years. The pain score significantly increased during the painful procedure when compared with the baseline measure and non‐painful procedure ( p < .001). Patients displayed a greater number of pain‐indicating behaviours during the painful procedure on day 6, compared with day 1 ( p < .05). This finding coincided with a reduced level of sedation and a greater level of consciousness. Conclusion The ESCID scale detects pain behaviours and discriminates among the different types of stimulation in patients with brain injury, who are uncommunicative and with mechanical ventilation, with good reliability. The ability for patients with brain injury to express behaviours is limited because of the low level of consciousness and the deep level of sedation. Impact This research will have an impact on the practice of pain assessment in patients with brain injury, representing a first step to adapt the content of the ESCID.