Development of a Measure of Nociception for Patients with Severe Brain Injury

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Development of a Measure of Nociception for Patients with Severe Brain Injury. / Whyte, John; Poulsen, Ingrid; Ni, Pengsheng; Eskildsen, Marianne; Guldager, Rikke.

I: The Clinical Journal of Pain, Bind 36, Nr. 4, 04.2020, s. 281-288.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Harvard

Whyte, J, Poulsen, I, Ni, P, Eskildsen, M & Guldager, R 2020, 'Development of a Measure of Nociception for Patients with Severe Brain Injury', The Clinical Journal of Pain, bind 36, nr. 4, s. 281-288. https://doi.org/10.1097/AJP.0000000000000811

APA

Whyte, J., Poulsen, I., Ni, P., Eskildsen, M., & Guldager, R. (2020). Development of a Measure of Nociception for Patients with Severe Brain Injury. The Clinical Journal of Pain, 36(4), 281-288. https://doi.org/10.1097/AJP.0000000000000811

CBE

Whyte J, Poulsen I, Ni P, Eskildsen M, Guldager R. 2020. Development of a Measure of Nociception for Patients with Severe Brain Injury. The Clinical Journal of Pain. 36(4):281-288. https://doi.org/10.1097/AJP.0000000000000811

MLA

Vancouver

Whyte J, Poulsen I, Ni P, Eskildsen M, Guldager R. Development of a Measure of Nociception for Patients with Severe Brain Injury. The Clinical Journal of Pain. 2020 apr;36(4):281-288. https://doi.org/10.1097/AJP.0000000000000811

Author

Whyte, John ; Poulsen, Ingrid ; Ni, Pengsheng ; Eskildsen, Marianne ; Guldager, Rikke. / Development of a Measure of Nociception for Patients with Severe Brain Injury. I: The Clinical Journal of Pain. 2020 ; Bind 36, Nr. 4. s. 281-288.

Bibtex

@article{d94cd198f38c44879ce837b54d17eec3,
title = "Development of a Measure of Nociception for Patients with Severe Brain Injury",
abstract = "OBJECTIVES: Severe brain injury is often accompanied by painful comorbidities and by concurrent limitations in the ability to report pain. Assessment of nociception aids diagnosis and helps balance reduction in suffering with avoidance of sedating medications. Existing assessment methods confound patients' level of consciousness with the intensity of nociception, complicating pain assessment as consciousness evolves. We sought to develop a measure of nociception that is independent of the level of consciousness.MATERIALS AND METHODS: We identified 15 behavioral and physiological items likely to be sensitive to nociception. We rated noncommunicative patients with traumatic brain injury in 4 different activities predicted to modulate nociception, on each of 2 days, one randomly chosen for acetaminophen administration. The level of consciousness and level of agitation were also measured.RASCH ANALYSIS: Rasch analysis was used to assess item fit to an underlying dimension of nociception.RESULTS: Five items that demonstrated poor fit to the dimension were removed. The 10 remaining items demonstrated acceptable fit. Scores were significantly influenced by activity and analgesic treatment and were largely independent of measures of consciousness and agitation. Accurate scores could be obtained in about 10 minutes and were robust to missing data.DISCUSSION: The results provide evidence that the Brain Injury Nociception Assessment Measure (BINAM) is reliable and feasible to administer. It can assess the intensity of nociception largely independent of the level of consciousness. Further research is warranted on the impact of BINAM use on the care of patients with severe traumatic brain injury.",
author = "John Whyte and Ingrid Poulsen and Pengsheng Ni and Marianne Eskildsen and Rikke Guldager",
year = "2020",
month = apr,
doi = "10.1097/AJP.0000000000000811",
language = "English",
volume = "36",
pages = "281--288",
journal = "The Clinical Journal of Pain",
issn = "0749-8047",
publisher = "LIPPINCOTT WILLIAMS & WILKINS",
number = "4",

}

RIS

TY - JOUR

T1 - Development of a Measure of Nociception for Patients with Severe Brain Injury

AU - Whyte, John

AU - Poulsen, Ingrid

AU - Ni, Pengsheng

AU - Eskildsen, Marianne

AU - Guldager, Rikke

PY - 2020/4

Y1 - 2020/4

N2 - OBJECTIVES: Severe brain injury is often accompanied by painful comorbidities and by concurrent limitations in the ability to report pain. Assessment of nociception aids diagnosis and helps balance reduction in suffering with avoidance of sedating medications. Existing assessment methods confound patients' level of consciousness with the intensity of nociception, complicating pain assessment as consciousness evolves. We sought to develop a measure of nociception that is independent of the level of consciousness.MATERIALS AND METHODS: We identified 15 behavioral and physiological items likely to be sensitive to nociception. We rated noncommunicative patients with traumatic brain injury in 4 different activities predicted to modulate nociception, on each of 2 days, one randomly chosen for acetaminophen administration. The level of consciousness and level of agitation were also measured.RASCH ANALYSIS: Rasch analysis was used to assess item fit to an underlying dimension of nociception.RESULTS: Five items that demonstrated poor fit to the dimension were removed. The 10 remaining items demonstrated acceptable fit. Scores were significantly influenced by activity and analgesic treatment and were largely independent of measures of consciousness and agitation. Accurate scores could be obtained in about 10 minutes and were robust to missing data.DISCUSSION: The results provide evidence that the Brain Injury Nociception Assessment Measure (BINAM) is reliable and feasible to administer. It can assess the intensity of nociception largely independent of the level of consciousness. Further research is warranted on the impact of BINAM use on the care of patients with severe traumatic brain injury.

AB - OBJECTIVES: Severe brain injury is often accompanied by painful comorbidities and by concurrent limitations in the ability to report pain. Assessment of nociception aids diagnosis and helps balance reduction in suffering with avoidance of sedating medications. Existing assessment methods confound patients' level of consciousness with the intensity of nociception, complicating pain assessment as consciousness evolves. We sought to develop a measure of nociception that is independent of the level of consciousness.MATERIALS AND METHODS: We identified 15 behavioral and physiological items likely to be sensitive to nociception. We rated noncommunicative patients with traumatic brain injury in 4 different activities predicted to modulate nociception, on each of 2 days, one randomly chosen for acetaminophen administration. The level of consciousness and level of agitation were also measured.RASCH ANALYSIS: Rasch analysis was used to assess item fit to an underlying dimension of nociception.RESULTS: Five items that demonstrated poor fit to the dimension were removed. The 10 remaining items demonstrated acceptable fit. Scores were significantly influenced by activity and analgesic treatment and were largely independent of measures of consciousness and agitation. Accurate scores could be obtained in about 10 minutes and were robust to missing data.DISCUSSION: The results provide evidence that the Brain Injury Nociception Assessment Measure (BINAM) is reliable and feasible to administer. It can assess the intensity of nociception largely independent of the level of consciousness. Further research is warranted on the impact of BINAM use on the care of patients with severe traumatic brain injury.

U2 - 10.1097/AJP.0000000000000811

DO - 10.1097/AJP.0000000000000811

M3 - Journal article

C2 - 32015255

VL - 36

SP - 281

EP - 288

JO - The Clinical Journal of Pain

JF - The Clinical Journal of Pain

SN - 0749-8047

IS - 4

ER -