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Updated: Jan 16, 2026

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
Preliminary Evidence Supporting Validity and Reliability of the Assessment for Appropriate Use of Opioids for
Barbara Resnick1, Rachel McPherson1, Sorah Levy1
1University of Maryland School of Nursing, Baltimore, Maryland.
Abstract:
Objective This study aimed to provide preliminary evidence supporting the validity and reliability of the 10-item Assessment for the Appropriate Use of Opioids in Long-Term Care. Design This analysis utilized baseline data from the study titled Testing the Pain Clinical Practice Guideline Using the Evidence Integration Triangle. Setting Six nursing homes were included in the study.Residents: Residents were eligible if they were 65 years of age or older and had evidence of pain or were receiving treatment for pain. The sample included 24 residents who were on opioid medications. Intervention/Procedure The authors collected data from electronic health records using research evaluators. Evidence of validity was established based on the internal structure of the measure and its relationship to other variables. Reliability was assessed through item reliability and internal consistency. Main Outcome Measures Descriptive variables included age, cognitive status, comorbidities, race, ethnicity, marital status, and education. Pain assessment was based on the Minimum Data Set: (1) a verbal response item and (2) four objective items. The Assessment for Appropriate Use of Opioids in Long-Term Care consists of 10 items evaluating the appropriate use of opioids. Results The mean age of the residents was 71.8 years (SD = 9.9). The majority were female (62%), White (54%), and non-Hispanic (92%). Evidence of validity was observed based on the internal structure of the measure, item fit, and associations with other variables. Reliability was supported by internal consistency and inter-rater reliability. Conclusions The study provided preliminary evidence of validity and reliability; however, future testing is needed with a larger, more heterogeneous sample.
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