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중환자 통증 평가 도구에 관한 체계적 문헌고찰

A Systematic Review on Pain Assessment Tools for Intensive Care Unit Patients

  • 투고 : 2020.01.02
  • 심사 : 2020.01.29
  • 발행 : 2020.02.28

초록

Purpose : The purpose of this study was to systematically review the measurement tools that are used to assess the pain of intensive care unit (ICU) patients. Method : In this systematic review, the studies published between 2009 and 2018 were selected based on the PRISMA flow chart. Data sources included MEDLINE, EMBASE, CINAHL, and Cochran. We assessed the quality of pain assessment tools reported in individual studies using Terwee et al.'s the Quality Criteria for Measurement Properties. Results : We reviewed 67 studies and 12 pain assessment tools that included two self-reported, seven observational, and three multifaced tools with observations and physiological indicators. The most frequently used tool was the Critical Care Pain Observation Tool. The Multidimensional Observational Pain Assessment Tool was rated the highest quality. Nine of the ten tools that included observations reported content validity, four reported construct validity and nine reported correlation coefficient. Conclusion : It was found that observational tools are appropriate for assessing pain in ICU patients with limited communication skills. To increase the validity and reliability of pain assessment in ICU patients, further research on the physiological indicators of pain is needed.

키워드

참고문헌

  1. Al Darwish, Z. Q., Hamdi, R., & Fallatah, S. (2016). Evaluation of pain assessment tools in patients receiving mechanical ventilation. AACN Advanced Critical Care, 27(2), 162-72. https://doi.org/10.4037/aacnacc2016287
  2. Bae, K. H., & Jeong, I. S. (2014). Pain perception of nurses and pain expression of patients in critical care units. Journal of Korean Academy of Nursing, 44(4), 437-445. https://doi.org/10.4040/jkan.2014.44.4.437
  3. Barr, J., Fraser, G. L., Puntillo, K., Ely, E. W., Gélinas, C., Dasta, J. F., . . . Coursin, D. B. (2013). Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Critical Care Medicine, 41(1), 263-306. https://doi.org/10.1097/CCM.0b013e3182783b72
  4. Buttes, P., Keal, G., Cronin, S. N., Stocks, L., & Stout, C. (2014). Validation of the critical-care pain observation tool in adult critically ill patients. Dimensions of Critical Care Nursing, 33(2), 78-81. https://doi.org/10.1097/DCC.0000000000000021
  5. Chanques, G., Pohlman, A., Kress, J. P., Molinari, N., De Jong, A., Jaber, S., & Hall, J. B. (2014). Psychometric comparison of three behavioural scales for the assessment of pain in critically ill patients unable to self-report. Critical Care, 18(5), R160. https://doi.org/10.1186/cc14000
  6. Choi, E. H., Kim, J. H., Ko, M. S., Kim, J. Y., Kwon, E. O., & Jang, I. S. (2013). Validation of critical care non-verbal pain scale for critically ill patients. Journal of Korean Clinical Nursing Research, 19(2), 245-254. https://doi.org/10.22650/JKCNR.2013.19.2.245
  7. Gelinas, C., Fillion, L., Puntillo, K. A., Viens, C., & Fortier, M. (2006). Validation of the critical-care pain observation tool in adult patients. American Journal of Critical Care, 15(4), 420-427. https://doi.org/10.4037/ajcc2006.15.4.420
  8. Gelinas, C., Harel, F., Fillion, L., Puntillo, K. A., & Johnston, C. C. (2009). Sensitivity and specificity of the critical-care pain observation tool for the detection of pain in intubated adults after cardiac surgery. Journal of Pain and Symptom Management, 37(1), 58-67. https://doi.org/10.1016/j.jpainsymman.2007.12.022
  9. Gelinas, C., Puntillo, K. A., Levin, P., & Azoulay, E. (2017). The behavior pain assessment tool for critically ill adults: A validation study in 28 countries. Pain, 158(5), 811-821. https://doi.org/10.1097/j.pain.0000000000000834
  10. Juarez, P., Bach, A., Baker, M., Duey, D., Durkin, S., Gulczynski, B., . . . Lefaiver, C. A. (2010). Comparison of two pain scales for the assessment of pain in the ventilated adult patient. Dimensions of Critical Care Nursing, 29(6), 307-315. https://doi.org/10.1097/DCC.0b013e3181f0c48f
  11. Kabes, A. M., Graves, J. K., & Norris, J. (2009). Further validation of the nonverbal pain scale in intensive care patients. Critical Care Nurse, 29(1), 59-66. https://doi.org/10.4037/ccn2009992
  12. Keane, K. M. (2013). Validity and reliability of the critical care pain observation tool: A replication study. Pain Management Nursing, 14(4), e216-e225. https://doi.org/10.1016/j.pmn.2012.01.002
  13. Kim, J. S., Kang, I. S., & Park, K. H. (2015). Reliability and validity of nonverbal pain assessment scale for patients who stayed a intensive care units. The Korean journal of Health Service Management, 9(2), 89-102. https://doi.org/10.12811/kshsm.2015.9.2.089
  14. Korean Society of Critical Care Medicine. (2012). 2010 Guidelines for use of sedatives and analgesics in adult Intensive care unit. Retrieved August 14, 2014, from http://ksccm.inforang.com/file/notice/KJCCM_file03.pdf
  15. Kwak, E. M., & Oh, H. Y. (2012). Validation of a Korean translated version of the critical care pain observation tool (CPOT) for ICU patients. Journal of Korean Academy of Nursing, 42(1), 76-84. https://doi.org/10.4040/jkan.2012.42.1.76
  16. Lee, H. O., Kim, Y. S., Lee, C. O., Hur, S. Y., & Kwon, I. G. (2013). Reliability and validity of a Korean version of the critical care pain observation tool (CPOT) for ICU patients unable to self report. Journal of Korean Critical Care Nursing, 6(1), 1-10.
  17. Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The, P. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Plos Medication, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097
  18. Oliveira, L. S., Macedo, M. P., Silva, S. A. M. D., Oliveira, A. P. D. F., & Santos, V. S. (2019). Pain assessment in critical patients using the behavioral pain scale. Brazilian Journal of Pain, 2(2), 112-116.
  19. Olsen, B. F., Rustoen, T., Sandvik, L., Jacobsen, M., & Valeberg, B. T. (2016). Results of implementing a pain management algorithm in intensive care unit patients: The impact on pain assessment, length of stay, and duration of ventilation. Journal of Critical Care, 36, 207-211. https://doi.org/10.1016/j.jcrc.2016.07.011
  20. Park Y. H., & Woo Y. C. (2015). Postoperative pain management. Journal of the Korean Medical Associateion, 58(11), 1011-1018. https://doi.org/10.5124/jkma.2015.58.11.1011
  21. Puntillo, K. A., Max, A., Timsit, J. F., Vignoud, L., Chanques, G., Robleda, G., . . . Ionescu, D. C. (2014). Determinants of procedural pain intensity in the intensive care unit. The Europain(R) study. American Journal of Respiratory and Critical Care Medicine, 189(1), 39-47.
  22. Puntillo, K. A., Stannard, D., Miaskowski, C., Kehrle, K., & Gleeson, S. (2002). Use of a pain assessment and intervention notation (P.A.I.N.) tool in critical care nursing practice: Nurses' evaluations. Heart & Lung - the Journal of Acute and Critical Care, 31(4), 303-314. https://doi.org/10.1067/mhl.2002.125652
  23. Rababa, M. (2018). Pain assessment in people with dementia: Remaining controversies. Glob Journal of Health Science, 10(5), 62-69. https://doi.org/10.5539/gjhs.v10n5p62
  24. Reade, M. C., & Finfer, S. (2014). Sedation and delirium in the intensive care unit. New England Journal of Medicine, 370(5), 444-454. https://doi.org/10.1056/NEJMra1208705
  25. Severgnini, P., Pelosi, P., Contino, E., Serafinelli, E., Novario, R., & Chiaranda, M. (2016). Accuracy of critical care pain observation tool and behavioral pain scale to assess pain in critically ill conscious and unconscious patients: Prospective, observational study. Journal of Intensive Care, 4(1), 68. https://doi.org/10.1186/s40560-016-0192-x
  26. Stites, M., & Surprise, J. (2014). Assessing pain in critically ill adults. Nursing Critical Care, 9(4), 36-41. https://doi.org/10.1097/01.CCN.0000451024.15197.3d
  27. Terwee, C. B., Bot, S. D., de Boer, M. R., van der Windt, D. A., Knol, D. L., Dekker, J., . . . de Vet, H. C. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60(1), 34-42. https://doi.org/10.1016/j.jclinepi.2006.03.012
  28. Voepel-Lewis, T., Zanotti, J., Dammeyer, J. A., & Merkel, S. (2010). Reliability and validity of the face, legs, activity, cry, consolability behavioral tool in assessing acute pain in critically ill patients. American Journal of Critical Care, 19(1), 55-61. https://doi.org/10.4037/ajcc2010624
  29. Wiegand, D. L., Wilson, T., Pannullo, D., Russo, M. M., Kaiser, K. S., Soeken, K., & McGuire, D. B. (2018). Measuring acute pain over time in the critically ill using the multidimensional objective pain assessment tool (MOPAT). Pain Management Nursing, 19(3), 277-287. https://doi.org/10.1016/j.pmn.2017.10.013
  30. Yamashita, A., Yamasaki, M., Matsuyama, H., & Amaya, F. (2017). Risk factors and prognosis of pain events during mechanical ventilation: A retrospective study. Journal of Intensive Care, 5(1), 17. https://doi.org/10.1186/s40560-017-0212-5