Validation of the Critical-Care Pain Observation Tool (CPOT) in pediatric patients undergoing orthopedic surgery
ABSTRACTBackground Postoperative pain cannot be measured accurately among many children with intellectual and developmental disabilities, resulting in underrecognition or delay in recognition of pain. The Critical-Care Pain Observation Tool (CPOT) is a pain assessment tool that has been widely valid...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Canadian Journal of Pain |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/24740527.2022.2156332 |
| _version_ | 1797448955113504768 |
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| author | Mandy M. J. Li Don Daniel Ocay Cynthia L. Larche Kelsey Vickers Neil Saran Jean A. Ouellet Céline Gélinas Catherine E. Ferland |
| author_facet | Mandy M. J. Li Don Daniel Ocay Cynthia L. Larche Kelsey Vickers Neil Saran Jean A. Ouellet Céline Gélinas Catherine E. Ferland |
| author_sort | Mandy M. J. Li |
| collection | DOAJ |
| description | ABSTRACTBackground Postoperative pain cannot be measured accurately among many children with intellectual and developmental disabilities, resulting in underrecognition or delay in recognition of pain. The Critical-Care Pain Observation Tool (CPOT) is a pain assessment tool that has been widely validated in critically ill and postoperative adults.Aims The objective of this study was to validate the CPOT for use with pediatric patients able to self-report and undergoing posterior spinal fusion surgery.Methods Twenty-four patients (10–18 years old) scheduled to undergo surgery were consented to this repeated-measure, within-subject study. To examine discriminative and criterion validation, CPOT scores and patients’ self-reports of pain intensity were collected prospectively by a bedside rater before, during, and after a nonnociceptive and nociceptive procedure on the day following surgery. Patients’ behavioral reactions were video recorded at the bedside and retrospectively viewed by two independent video raters to examine interrater and intrarater reliability of CPOT scores.Results Discriminative validation was supported with higher CPOT scores during the nociceptive procedure than during the nonnociceptive procedure. Criterion validation was supported with a moderate positive correlation between the CPOT scores and the patients’ self-reported pain intensity during the nociceptive procedure. A CPOT cutoff score of ≥2 was associated with the maximum sensitivity (61.3%) and specificity (94.1%). Reliability analyses revealed poor to moderate agreement between bedside and video raters and moderate to excellent consistency within video raters.Conclusions These findings suggest that the CPOT may be a valid tool to detect pain in pediatric patients in the acute postoperative inpatient care unit after posterior spinal fusion. |
| first_indexed | 2024-03-09T14:18:03Z |
| format | Article |
| id | doaj.art-cb35e2c15dde48a98a05da1e79ae7be3 |
| institution | Directory Open Access Journal |
| issn | 2474-0527 |
| language | English |
| last_indexed | 2024-03-09T14:18:03Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Canadian Journal of Pain |
| spelling | doaj.art-cb35e2c15dde48a98a05da1e79ae7be32023-11-28T20:20:16ZengTaylor & Francis GroupCanadian Journal of Pain2474-05272023-12-017110.1080/24740527.2022.2156332Validation of the Critical-Care Pain Observation Tool (CPOT) in pediatric patients undergoing orthopedic surgeryMandy M. J. Li0Don Daniel Ocay1Cynthia L. Larche2Kelsey Vickers3Neil Saran4Jean A. Ouellet5Céline Gélinas6Catherine E. Ferland7Department of Clinical Research, Shriners Hospitals for Children–Canada, Montreal, Quebec, CanadaDepartment of Clinical Research, Shriners Hospitals for Children–Canada, Montreal, Quebec, CanadaDepartment of Clinical Research, Shriners Hospitals for Children–Canada, Montreal, Quebec, CanadaDepartment of Clinical Research, Shriners Hospitals for Children–Canada, Montreal, Quebec, CanadaDepartment of Clinical Research, Shriners Hospitals for Children–Canada, Montreal, Quebec, CanadaDepartment of Clinical Research, Shriners Hospitals for Children–Canada, Montreal, Quebec, CanadaIngram School of Nursing, McGill University, Montreal, Quebec, CanadaDepartment of Clinical Research, Shriners Hospitals for Children–Canada, Montreal, Quebec, CanadaABSTRACTBackground Postoperative pain cannot be measured accurately among many children with intellectual and developmental disabilities, resulting in underrecognition or delay in recognition of pain. The Critical-Care Pain Observation Tool (CPOT) is a pain assessment tool that has been widely validated in critically ill and postoperative adults.Aims The objective of this study was to validate the CPOT for use with pediatric patients able to self-report and undergoing posterior spinal fusion surgery.Methods Twenty-four patients (10–18 years old) scheduled to undergo surgery were consented to this repeated-measure, within-subject study. To examine discriminative and criterion validation, CPOT scores and patients’ self-reports of pain intensity were collected prospectively by a bedside rater before, during, and after a nonnociceptive and nociceptive procedure on the day following surgery. Patients’ behavioral reactions were video recorded at the bedside and retrospectively viewed by two independent video raters to examine interrater and intrarater reliability of CPOT scores.Results Discriminative validation was supported with higher CPOT scores during the nociceptive procedure than during the nonnociceptive procedure. Criterion validation was supported with a moderate positive correlation between the CPOT scores and the patients’ self-reported pain intensity during the nociceptive procedure. A CPOT cutoff score of ≥2 was associated with the maximum sensitivity (61.3%) and specificity (94.1%). Reliability analyses revealed poor to moderate agreement between bedside and video raters and moderate to excellent consistency within video raters.Conclusions These findings suggest that the CPOT may be a valid tool to detect pain in pediatric patients in the acute postoperative inpatient care unit after posterior spinal fusion.https://www.tandfonline.com/doi/10.1080/24740527.2022.2156332Critical-Care Pain Observation Toolpediatricvalidationsurgeryinpatient |
| spellingShingle | Mandy M. J. Li Don Daniel Ocay Cynthia L. Larche Kelsey Vickers Neil Saran Jean A. Ouellet Céline Gélinas Catherine E. Ferland Validation of the Critical-Care Pain Observation Tool (CPOT) in pediatric patients undergoing orthopedic surgery Canadian Journal of Pain Critical-Care Pain Observation Tool pediatric validation surgery inpatient |
| title | Validation of the Critical-Care Pain Observation Tool (CPOT) in pediatric patients undergoing orthopedic surgery |
| title_full | Validation of the Critical-Care Pain Observation Tool (CPOT) in pediatric patients undergoing orthopedic surgery |
| title_fullStr | Validation of the Critical-Care Pain Observation Tool (CPOT) in pediatric patients undergoing orthopedic surgery |
| title_full_unstemmed | Validation of the Critical-Care Pain Observation Tool (CPOT) in pediatric patients undergoing orthopedic surgery |
| title_short | Validation of the Critical-Care Pain Observation Tool (CPOT) in pediatric patients undergoing orthopedic surgery |
| title_sort | validation of the critical care pain observation tool cpot in pediatric patients undergoing orthopedic surgery |
| topic | Critical-Care Pain Observation Tool pediatric validation surgery inpatient |
| url | https://www.tandfonline.com/doi/10.1080/24740527.2022.2156332 |
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