중환자 통증사정 도구 개발

Abstract

Purpose: The purpose of this study was to develop a reliable and valid pain assessment tool suitable for critically ill patients with communication problem in Korean intensive care unit. Methods: This pain assessment tool,Critical Care Non-verbal Pain Scale (CNPS), was developed based on review of national and international researches. Data were collected from ten intensive care units at five major general hospitals in Seoul. Reliability and validity were tested during performance of position change and endotracheal suctioning. Pain was measured before, during, and 20 minutes after the two procedures. Results: Interrater reliability of the CNPS was analyzed by ICC (Intraclass correlation coefficients). ICC values were significant from .833 to .883. Significant correlation between the FPS (Face Pain Scale) scores and the CNPS scores verified concurrent validity of the CNPS. For position change, CNPS scores increased significantly between before and during (t=-23.399, p<.001) and decreased significantly between during and 20 minutes after (t=22.760, p<.001). For endotracheal suctioning, CNPS scores increased significantly between before and during (t=-29.064, p<.001) and significantly decreased between during and 20 minutes after (t=28.194, p<.001), verifying construct validity of the CNPS. Conclusion: Results indicate that the CNPS can be used to assess pain of critically ill patients who have communication problem.