Development and Psychometric Evaluation of the Comprehensive Nonverbal Pain Assessment Tool (CNPAT) in the Intensive Care Unit

Background: Pain assessment in patients admitted to the intensive care unit (ICU) is debatable due to the critical situation of patients and failure in self-report pain.Aim: The present study was performed with aim to develop and psychometrically evaluate the Comprehensive Nonverbal Pain Assessment Tool (CNPAT) in the ICU admitted patients.Method: This methodological study was conducted following three phases. The first phase was a review of past studies and the design and writing of the items of the tool, the second phase includes the psychological characteristics of the tool (validity, reliability, sensitivity and specificity) and the third phase was the evaluation of comprehensive pain tool in patients with verbal inability admitted to ICUs from March to September 2023 in 5 hospitals affiliated to Shahid Beheshti University of Medical Sciences.Results: In the first phase by reviewing the titles and ensuring their relevance to the current study, 21 studies were finally selected. Then six steps of psychometric scale were done and finally the comprehensive scale was suggested for pain assessment. This scale has 8 items for pain assessment scoring between 0-18, each item scoring between 0-2 or 0-3. The result of third phase showed that the total mean score of the indicator in the three modes was 3.8±1.62, 9.83±2.61, and 3.5±1.45 before the intervention, during suctioning, and 20 minutes after the intervention, respectively (p 0.001).Implications for Practice: The Comprehensive Nonverbal Pain Assessment Tool (CNPAT) is appropriate for pain assessment in patients who cannot self-report pain.