Scales for the assessment of pain in the intensive care unit. Systematic review

ABSTRACT

BACKGROUND AND OBJECTIVES:

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Thus, pain is difficult to evaluate, especially in patients undergoing mechanical ventilation in an intensive care unit. However, there are several instruments to assess these patients’ pain. Thus, the aims of the present study were described and characterize the psychometric characteristics of the intensive care unit pain assessment scales.

CONTENTS:

A systematic review in the electronic databases of Pubmed, LILACS, Cochrane Library and Scielo was performed, without time restrictions. The focus of this evidence synthesis is to examine the validity, reproducibility, and responsiveness of intensive care unit pain scales. 58 studies were included. Cronbach alpha ranged from 0.31 to 0.96 and the intraclass correlation coefficient from 0.25 to 1.00. A cross-cultural adaptation was performed in 28 studies for use in language Portuguese (Brazil), Chinese, Italian, Swedish, Portuguese (Portugal), English, Dutch, Turkish, Persian, Danish, Polish, Spanish and Greek.

CONCLUSION:

Among the available scales to measure pain in non-responsive patients, the data is not enough to indicate the superiority between them. In Brazil, most studies demonstrated that the pain scales had satisfactory validity, reliability, and reproducibility rates. Thus, when deciding which scale to use, the convenience of application and familiarity of the team should be considered.

Keywords:
Critical care; Intensive care units; Pain measurement; Reproducibility of results