Author Of 1 Presentation
PRELIMINARY VALIDATION OF THE COMFORT BEHAVIORAL SCALE IN MECHANICALLY VENTILATED COGNITIVE IMPAIRED CHILDREN
- Orsola Gawronski, Italy
- Micaela Monoscalco,
- Maria Rosaria Gammone,
- Fabrizio Chiusolo, Italy
- Daniela Carbonari,
- Arianna Meschini,
- Marina Franci,
- Francesca Stoppa,
- Federica Cancani,
- Francesca Broccati,
- Valentina Costantini,
- Michela Di Furia,
- Flaminia Passi, Italy
- Immacolata Dall'Oglio,
- Emanuela Tiozzo,
- Lucilla Rava',
- Monique Van Dijk,
Abstract
Background
Children with cognitive impairment generally express their pain through idiosyncratic, subjective behavior. The Comfort Behavior Scale (CBS) is validated for the assessment of distress, pain and sedation in mechanically ventilated children in PICU. However it has not been validated yet in children with cognitive impairment.
Objectives
To explore the criterion validity of CBS comparing it with the Individualized Numeric Rating Scale(INRS) and revised FLACC scale (R-FLACC) for pain.
Methods
Observational validation pilot study from March to September 2018 in 3 PICU’s in a tertiary care pediatric hospital. Pain and sedation was assessed in 16 patients before and after tracheal suctioning by two independent clinicians, using the CBS, INRS and R-FLACC. Interrater reliability using linearly weighted kappa was evaluated at the beginning of the study. To evaluate the correlation between scales the Spearman rho correlation coefficient was applied.
Results
Results: 38 tracheal suctioning events were assessed on 16 cognitively impaired patients. Interrater reliability between nurses was evaluated on 11 events: interrater reliability was maximum for the R-FlACC (Cohen’s kappa = 1), and moderate for the CBS (Cohen’s kappa = 0.42): The correlation between R-FLACC and CBS was was 0.75 before and 0.80 after the procedure.
Conclusion
This is the first study to validate a standardized pain and sedation scale on a population of mechanically ventilated patients with cognitive impairment. Results seem promising for the use of CBS on this patient population.