中文版重症疼痛观察工具在机械通气患者中的应用

Reliability and validity of Chinese version of Critical-Care Pain Observation Tool in patients with mechanical ventilation

目的通过将翻译重症疼痛观察工具(Critical-Care Pain Observation Tool,CPOT)翻译成中文版,并进行文化调适,检验其在无主诉能力ICU机械通气患者中的信效度。方法采用翻译、回译、文化调适确定中文版CPOT的内容。由5名专家对汉化版CPOT进行内容效度测评。由护士A、护士B分别对70例无主诉能力的ICU机械通气患者进行平静状态、无痛操作状态、侵袭性操作状态的疼痛评分,计算内部一致性信度Cronbach'sα系数;计算护士A与护士B的评分相关性,测算评定者间信度;再由护士A对同1例患者同一状态下进行再次疼痛评分,计算两次评分相关性,评测重测信度。结果中文版CPOT的CVI为1,Cronbach'sα=0.84,不同护士间评分Pearson相关系数为0.86,同一护士两次评分间Pearson相关系数为0.90。结论中文版CPOT具有良好的信效度,适用于无主诉能力机械通气患者的疼痛评估。

Objective To generate a Chinese version of Critical-Care Pain Observation Tool（ CPOT） and test its psychometric properties in intensive care unit（ ICU） patients with mechanical ventilation. Methods After translation,psychometric testing which included content validity,internal consistency reliability,inter-rater reliability,test-retest reliability was conducted. The content validity was tested by 5 experts. Two research nurses observed patients＇ pain-related behaviors at rest,and during non-painful or painful procedures. A total of70 patients in South Branch of Shanghai General Hospital,Shanghai Jiao Tong University were involved in the research. Results The Chinese version of CPOT captured the contents of original tool with appropriate adaptation to the cultural context. The CVI was 1. The Cronbach＇ α was 0. 84. The inter-rater reliability and test-retest reliability were confirmed by good Pearson correlations（ r = 0. 86,P〈0. 01; r = 0. 90,P〈0. 01）.Conclusion Chinese version of CPOT has good psychometric properties and could be used as a reliable and valid instrument for pain assessment in nonverbal-ventilated patients.