Cross-cultural adaptation and validation of the Indonesian version of the Critical-care Pain Observation Tool.
Luthfi Fauzy Asriyanto, Nur Chayati
PMID 38352280WHAT IT FOUND
The Indonesian version of the Critical-care Pain Observation Tool reliably detects pain in ICU patients who cannot speak.
Scores correlate strongly with verbal self-reports and show high consistency between nurses, confirming it is a valid tool for assessing pain in patients with decreased consciousness.
Key findings
01The tool showed high internal consistency (Cronbach’s α = 0.82) and strong agreement between different nurse assessors (Kappa > 0.70), meaning it produces reliable results regardless of who is observing.
02CPOT scores correlated strongly with patients' own verbal pain reports (Spearman’s r > 0.80), validating that the behavioral observations accurately reflect the pain intensity experienced by the patient.
03Pain scores increased significantly during the body-turning procedure compared to rest, demonstrating the tool's sensitivity to nociceptive pain caused by nursing care activities.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample size was small (52 participants), and only 6 patients were intubated, limiting generalizability to the broader mechanically ventilated ICU population. The study relied on body-turning as the sole nociceptive stimulus, which may not capture pain responses to other common ICU procedures like suctioning or wound care. Behavioral pain assessment requires clinical competence; the results may not translate to settings where nurses have not received specific training in using the CPOT.
Declared interests
The study was funded by the Research and Innovation Institute Universitas Muhammadiyah Yogyakarta. The authors declared no competing interests.
The easy way to misread this
Do not assume this tool works for all non-verbal patients without training. The authors note that behavioral pain assessment requires clinical competence, and the study included only a small number of intubated patients, so its performance in heavily sedated or paralyzed patients is less certain.