Pain assessment using the critical-care pain observation tool in Chinese critically ill ventilated adults

The psychometric properties of the Critical-Care Pain Observation Tool (CPOT) need to be tested in general intensive care unit patient populations in China.

To further evaluate the psychometric properties of the CPOT and provide a pain assessment method for Chinese critically ill ventilated adults by validating a translation of the CPOT.

A total of 63 conscious ventilated Chinese adults were repeatedly assessed by two independent raters using the CPOT at rest as well as before and during the two procedures: 1) nociceptive procedure (turning) and 2) non-nociceptive procedure (taking noninvasive blood pressure). A total of 12 assessments were included.

The principal component factor analysis revealed that the domain structure of the CPOT was acceptable. Cronbach's α coefficient as a measure for the internal consistency ranged from 0.57 to 0.86; intraclass correlation coefficients as a measure for inter-rater reliability ranged from 0.80 to 0.91; Spearman nonparametric coefficients as a measure for test-retest reliability ranged from 0.81 to 0.93. The CPOT total score was significantly higher during the nociceptive procedure, indicating that its discriminant validity was good. Self-reported pain was obtained as the gold standard; the receiver operating characteristic curve analysis determined the best cutoff value of the CPOT (>2) with the specificity (73.3-81.8%) and sensitivity (80.8-89.4%) as well as the area under the curve (range 0.849-0.902).

The CPOT has good psychometric properties and can be used as a reliable and valid instrument for pain assessment in Chinese critically ill ventilated adults.