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Enfermería: Cuidados Humanizados

Print version ISSN 1688-8375On-line version ISSN 2393-6606


RIVAS RIVEROS, Edith et al. Pain valuation scales in non-communicable critical patients:. Enfermería (Montevideo) [online]. 2018, vol.7, n.1, pp.57-73. ISSN 1688-8375.

The assessment of pain is perceived with difficulty when patients are in critical condition, since their condition makes self-report impossible. The objective was to determine the reliability of pain assessment scales in critical non-communicative patients (BPS, CPOT, NVPS, ESCID and Campbell scales). It was a systematic review in electronic databases: Pubmed, ScienceDirect, VHL, Scielo and Cochrane Library; consulting the electronic journals Nursing in Critical Care, Journal of Pain and Symptom Management, Pain Medicine, Pain Management Nursing, Critical Care, Acta Anaesthesiologica Scandinavica, Intensive Nursing, Intensive Care Medicine, International Journal of Nursing Studies, Archives of Trauma Research, Journal Brazilian Institute of Intensive Therapy and The Journal of Pain. Eligibility criteria applied: critical patients with inability to communicate verbally, in writing and / or through intentional gestures; over 18 years; of both sexes; that the scales contain Cronbach's alpha psychometric property that measures both reliability (internal consistency) and criterion validity; that the articles are in their full version; in English, Portuguese and Spanish and updated, with less than ten years. The evaluation of the studies and summary of results, focused on: a) Database / Magazine, Sample, Design, Scale and Cronbach's α. b) Quality of included studies, c) Scottish Intercollegiate Guidelines Network evidence levels and quality of scientific evidence; Likewise, risk of bias has been assessed. Of 114 records, 13 articles were included in the review to finally select 4 studies of scale Behavioral Pain Scale that reached the highest reliability in a study conducted in the United States in which the Cronbach's Alpha fluctuated between 0.80 to 0.92. BPS showed greater reliability and criterion validity to assess pain in the patients under study. The strength of the results is the magnitude and relevance of the problem that gives rise to the need to continue developing high quality evidence (studies of greater methodological rigor) to respond to the needs of patients. Likewise, the results are essential components for decision-making, which should be reflected in the Clinical Guide for non-communicative patient management. It is concluded that it is necessary to continue fostering the development of research in this line, which evaluates a subject as sensitive as pain, which the Ministry of Health has cataloged as the fifth vital sign

Keywords : Critical Care; Pain; Dimension of Pain; Pain threshold; Pain management.

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