Pain assessment in the intensive care unit: Development and psychometric testing of the nonverbal pain assessment tool

Background andardized tools measure pain in nonverbal patients in the intensive care unit (ICU). Evidence exists that patient behaviors provide important information about pain in those unable to report their pain. ive nverbal Pain Assessment Tool (NPAT), a behavioral pain assessment tool, was developed for the nonverbal adult patient in the ICU. Content and criterion validity and internal and interrater reliability were evaluated. s lidity of NPAT was assessed against the patientsʹ self-reports of pain. Interrater reliability was tested by 5 teams of 2 nurses assessing pain in nonverbal adult patients in 4 different ICUs. s ol underwent 2 revisions and involved 270 patients. During the final evaluation, strong internal reliability (chronbachʹs α, .82; 95% confidence interval), moderately strong interrater reliability (concordance coefficient, .72; 95% confidence interval; and weighted κ statistic, .35), and moderately strong validity (concordance coefficient, .66; 95% confidence interval) were achieved. sion AT was found to possess moderately strong validity and strong internal and interrater reliability. It is easy to use, and provides a standard approach to assessing pain in the nonverbal adult patient.