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Related Concept Videos

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Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
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Related Experiment Video

Updated: Apr 28, 2026

A Protocol of Manual Tests to Measure Sensation and Pain in Humans
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Nurses assessing pain with the Nociception Coma Scale: interrater reliability and validity.

Peter Vink1, Anne Maria Eskes2, Robert Lindeboom3

  • 1Department of Neurosensory Specialties and Psychiatry, Academic Medical Center, Amsterdam, The Netherlands; Department of Neurosurgery, Academic Medical Center, Amsterdam, The Netherlands.

Pain Management Nursing : Official Journal of the American Society of Pain Management Nurses
|June 11, 2014
PubMed
Summary

The Nociception Coma Scale (NCS) and NCS-Revised (NCS-R) are reliable tools for assessing pain in patients with disorders of consciousness (DOC) after acquired brain injury (ABI). Nurses can effectively use these scales, regardless of extensive experience, for accurate pain evaluation.

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Nursing Science

Background:

  • Pain assessment in patients with disorders of consciousness (DOC) due to acquired brain injury (ABI) is challenging.
  • The Nociception Coma Scale (NCS) and its revised version (NCS-R) are designed to address this clinical need.
  • Reliable and valid tools are crucial for effective pain management in this vulnerable population.

Purpose of the Study:

  • To evaluate the interrater reliability of the NCS and NCS-R among nurses for pain assessment in ABI patients with DOC.
  • To further validate the NCS and NCS-R by assessing their ability to discriminate between the presence and absence of pain.
  • To explore the influence of nurses' education and experience on scale reliability.

Main Methods:

  • A study involving 10 hospitalized ABI patients with DOC.
  • Video recordings of patients during baseline, tactile, and noxious stimulation.
  • Assessment of 30 recordings by 27 nurses using the NCS and NCS-R, totaling 270 assessments.
  • Interrater reliability estimated using intraclass correlations (ICC).

Main Results:

  • Excellent and equal average measures reliability for both NCS and NCS-R total scores (ICC = 0.95).
  • High reliability for item scores (ICC range: 0.87–0.95).
  • Nurses with associate or baccalaureate degrees demonstrated reliable use of the scales; extensive ABI experience was not a predictor of agreement.

Conclusions:

  • The NCS and NCS-R are valid and reproducible pain assessment scales for nurses caring for ABI patients with DOC.
  • These scales can be effectively utilized by nurses with varying educational backgrounds.
  • The findings support the use of NCS and NCS-R in clinical practice for improved pain management in DOC patients.