Development and preclinical testing of the critical care pain observation tool for family caregiver use (CPOT‐Fam)

Abstract Background and Aims Pain assessment in noncommunicative intensive care unit (ICU) patients is challenging. For these patients, family caregivers (i.e., family members, friends) may be able to assist in pain assessment by identifying individualistic signs of pain due to their intimate patien...

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Main Authors: Anmol Shahid, Bonnie G. Sept, Shelly Longmore, Victoria S. Owen, Stephana J. Moss, Andrea Soo, Kirsten M. Fiest, Céline Gélinas, Henry T. Stelfox
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Health Science Reports
Subjects:
Online Access:https://doi.org/10.1002/hsr2.986
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author Anmol Shahid
Bonnie G. Sept
Shelly Longmore
Victoria S. Owen
Stephana J. Moss
Andrea Soo
Kirsten M. Fiest
Céline Gélinas
Henry T. Stelfox
author_facet Anmol Shahid
Bonnie G. Sept
Shelly Longmore
Victoria S. Owen
Stephana J. Moss
Andrea Soo
Kirsten M. Fiest
Céline Gélinas
Henry T. Stelfox
author_sort Anmol Shahid
collection DOAJ
description Abstract Background and Aims Pain assessment in noncommunicative intensive care unit (ICU) patients is challenging. For these patients, family caregivers (i.e., family members, friends) may be able to assist in pain assessment by identifying individualistic signs of pain due to their intimate patient knowledge. This study adapted the critical care pain observation tool (CPOT) to facilitate pain assessment in adult ICU patients by family caregivers. Methods This study was conducted through three distinct phases: (1) CPOT adaptation for family caregiver use (to create the CPOT‐Fam): A working group met monthly to adapt the CPOT and develop educational material and sample cases for practice scoring until consensus was reached. (2) CPOT‐Fam preclinical testing: Family caregiver study participants viewed educational materials and scored four randomly selected sample cases using the CPOT‐Fam. Scores were compared to reference scores to assess agreement and identify CPOT‐Fam sections requiring revision. Open‐ended feedback on the CPOT‐Fam was collected. (3) CPOT‐Fam revision: the CPOT‐Fam was revised by the working group considering score agreement and feedback received from study participants. Results Of the n = 30 participants, n = 14 (47.0%) had experience with an ICU patient. Agreement between CPOT‐Fam participant scores and reference scores were highest for the vocalization dimension (Is the patient making any sounds?; Intraclass correlation coefficient; ICC = 1.0) and lowest for the body movements dimension (What are the patient's body movements like?; ICC = 0.85. Participants indicated they found the CPOT‐Fam to be “informative” and “easy‐to‐use” but “not graphic enough”; participants also indicated that descriptors like “lack of breath” and “struggling to move” are helpful with identifying individualistic behaviors of pain exhibited by their loved ones. Conclusion The CPOT‐Fam shows ease of use and may be of value in involving family caregivers in ICU care. Clinical pilot testing is needed to determine feasibility and acceptability and identify further areas for refinement.
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spelling doaj.art-c4935efcbdb543909037287ebb202b312023-08-24T06:32:46ZengWileyHealth Science Reports2398-88352023-01-0161n/an/a10.1002/hsr2.986Development and preclinical testing of the critical care pain observation tool for family caregiver use (CPOT‐Fam)Anmol Shahid0Bonnie G. Sept1Shelly Longmore2Victoria S. Owen3Stephana J. Moss4Andrea Soo5Kirsten M. Fiest6Céline Gélinas7Henry T. Stelfox8Department of Critical Care Medicine, Cumming School of Medicine University of Calgary & Alberta Health Services Calgary Alberta CanadaDepartment of Critical Care Medicine, Cumming School of Medicine University of Calgary & Alberta Health Services Calgary Alberta CanadaDepartment of Critical Care Medicine, Cumming School of Medicine University of Calgary & Alberta Health Services Calgary Alberta CanadaDepartment of Critical Care Medicine, Cumming School of Medicine University of Calgary & Alberta Health Services Calgary Alberta CanadaDepartment of Critical Care Medicine, Cumming School of Medicine University of Calgary & Alberta Health Services Calgary Alberta CanadaDepartment of Critical Care Medicine, Cumming School of Medicine University of Calgary & Alberta Health Services Calgary Alberta CanadaDepartment of Critical Care Medicine, Cumming School of Medicine University of Calgary & Alberta Health Services Calgary Alberta CanadaCentre for Nursing Research and Lady Davis Institute, Ingram School of Nursing, Jewish General Hospital—CIUSSS West‐Central Montreal McGill University Montreal CanadaDepartment of Critical Care Medicine, Cumming School of Medicine University of Calgary & Alberta Health Services Calgary Alberta CanadaAbstract Background and Aims Pain assessment in noncommunicative intensive care unit (ICU) patients is challenging. For these patients, family caregivers (i.e., family members, friends) may be able to assist in pain assessment by identifying individualistic signs of pain due to their intimate patient knowledge. This study adapted the critical care pain observation tool (CPOT) to facilitate pain assessment in adult ICU patients by family caregivers. Methods This study was conducted through three distinct phases: (1) CPOT adaptation for family caregiver use (to create the CPOT‐Fam): A working group met monthly to adapt the CPOT and develop educational material and sample cases for practice scoring until consensus was reached. (2) CPOT‐Fam preclinical testing: Family caregiver study participants viewed educational materials and scored four randomly selected sample cases using the CPOT‐Fam. Scores were compared to reference scores to assess agreement and identify CPOT‐Fam sections requiring revision. Open‐ended feedback on the CPOT‐Fam was collected. (3) CPOT‐Fam revision: the CPOT‐Fam was revised by the working group considering score agreement and feedback received from study participants. Results Of the n = 30 participants, n = 14 (47.0%) had experience with an ICU patient. Agreement between CPOT‐Fam participant scores and reference scores were highest for the vocalization dimension (Is the patient making any sounds?; Intraclass correlation coefficient; ICC = 1.0) and lowest for the body movements dimension (What are the patient's body movements like?; ICC = 0.85. Participants indicated they found the CPOT‐Fam to be “informative” and “easy‐to‐use” but “not graphic enough”; participants also indicated that descriptors like “lack of breath” and “struggling to move” are helpful with identifying individualistic behaviors of pain exhibited by their loved ones. Conclusion The CPOT‐Fam shows ease of use and may be of value in involving family caregivers in ICU care. Clinical pilot testing is needed to determine feasibility and acceptability and identify further areas for refinement.https://doi.org/10.1002/hsr2.986critical care pain observation toolfamily partnershipintensive care unit painpain assessmentquality improvementtool development
spellingShingle Anmol Shahid
Bonnie G. Sept
Shelly Longmore
Victoria S. Owen
Stephana J. Moss
Andrea Soo
Kirsten M. Fiest
Céline Gélinas
Henry T. Stelfox
Development and preclinical testing of the critical care pain observation tool for family caregiver use (CPOT‐Fam)
Health Science Reports
critical care pain observation tool
family partnership
intensive care unit pain
pain assessment
quality improvement
tool development
title Development and preclinical testing of the critical care pain observation tool for family caregiver use (CPOT‐Fam)
title_full Development and preclinical testing of the critical care pain observation tool for family caregiver use (CPOT‐Fam)
title_fullStr Development and preclinical testing of the critical care pain observation tool for family caregiver use (CPOT‐Fam)
title_full_unstemmed Development and preclinical testing of the critical care pain observation tool for family caregiver use (CPOT‐Fam)
title_short Development and preclinical testing of the critical care pain observation tool for family caregiver use (CPOT‐Fam)
title_sort development and preclinical testing of the critical care pain observation tool for family caregiver use cpot fam
topic critical care pain observation tool
family partnership
intensive care unit pain
pain assessment
quality improvement
tool development
url https://doi.org/10.1002/hsr2.986
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