Translation and cultural adaptation of an objective pain assessment tool for Finnish ICU patients
Sammanfattning
Aim
The purpose of this study was to culturally validate three pain measurement instruments [Behavioral
Pain Scale (BPS), the Critical-Care Pain Observation Tool (CPOT) and the Nonverbal Adult Pain
Assessment Scale (NVPS)] for sedated intensive care patients and in doing so to prepare the tools for
psychometric testing in the Finnish intensive care environment.
Background
Most patients feel pain during their stay in an intensive care unit. Pain recognition and assessment
is the first step towards effective pain management. The BPS, CPOT and NVPS are the most valid and
reliable pain assessment instruments developed to objectively assess pain in sedated intensive
care patients.
Method
The translation and cultural adaptation of the instruments were done according to the guidelines of
the International Society for Pharmacoeconomics and Outcomes (ISPOR). The process included 10
phases aiming to produce semantically correct Finnish versions of the pain assessment instruments.
This translation process was chosen due to its rigorousness and systematic approach.
Results
The 10-step translation and cultural validation process were successfully conducted, although it was
complex and time-consuming. The resulting Finnish versions of the three pain assessment
instruments showed good evidence of content and conceptual equivalence. Although further work is
needed to test these instruments in the Finnish intensive care context, the current Finnish versions
are potential instruments for clinicians to use.
Conclusion
Deciding when this high-quality process is needed requires thorough consideration. However, it is
worthwhile to use it when implementing new instruments at a national level. We need a valid, reliable
and feasible instrument for pain assessment in sedated intensive care patients in Finland. The next
step in our process is conducting psychometric testing of these three instruments to choose the tool
with the best properties to be implemented in clinical practice.
Published by arrangement with John Wiley & Sons.