Behavioral changes in brain-injured critical care adults with different levels of consciousness during nociceptive stimulation: An observational study
Purpose: The primary objective of this study was to describe the frequency of behaviors observed during rest, a non-nociceptive procedure, and a nociceptive procedure in brain-injured intensive care unit (ICU) patients with different levels of consciousness (LOC). Second, it examined the inter-rater...
| Main Authors: | , |
|---|---|
| Format: | Journal Article |
| Published: |
Springer Verlag
2014
|
| Online Access: | http://hdl.handle.net/20.500.11937/17587 |
| _version_ | 1848749505162248192 |
|---|---|
| author | Roulin, M. Ramelet, Anne-Sylvie |
| author_facet | Roulin, M. Ramelet, Anne-Sylvie |
| author_sort | Roulin, M. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Purpose: The primary objective of this study was to describe the frequency of behaviors observed during rest, a non-nociceptive procedure, and a nociceptive procedure in brain-injured intensive care unit (ICU) patients with different levels of consciousness (LOC). Second, it examined the inter-rater reliability and discriminant and concurrent validity of the behavioral checklist used. Methods: The non-nociceptive procedure involved calling the patient and shaking his/her shoulder. The nociceptive procedure involved turning the patient. The frequency of behaviors was recorded using a behavioral checklist. Results: Patients with absence of movement, or stereotyped flexion or extension responses to a nociceptive stimulus displayed more behaviors during turning (median 5.5, range 0-14) than patients with localized responses (median 4, range 0-10) or able to self-report their pain (median 4, range 0-10). Face flushing, clenched teeth, clenched fist, and tremor were more frequent in patients with absence of movement, or stereotyped responses to a nociceptive stimulus. The reliability of the checklist was supported by a high intra-class correlation coefficient (0.77-0.92), and the internal consistency was acceptable in all three groups (KR 20, 0.71-0.85). Discriminant validity was supported as significantly more behaviors were observed during nociceptive stimulation than at rest. Concurrent validity was confirmed as checklist scores were correlated to the patients' self-reports of pain (r s = 0.53; 95 % CI 0.21-0.75). Conclusion: Brain-injured patients reacted significantly more during a nociceptive stimulus and the number of observed behaviors was higher in patients with a stereotyped response. |
| first_indexed | 2025-11-14T07:22:00Z |
| format | Journal Article |
| id | curtin-20.500.11937-17587 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T07:22:00Z |
| publishDate | 2014 |
| publisher | Springer Verlag |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-175872017-09-13T15:44:15Z Behavioral changes in brain-injured critical care adults with different levels of consciousness during nociceptive stimulation: An observational study Roulin, M. Ramelet, Anne-Sylvie Purpose: The primary objective of this study was to describe the frequency of behaviors observed during rest, a non-nociceptive procedure, and a nociceptive procedure in brain-injured intensive care unit (ICU) patients with different levels of consciousness (LOC). Second, it examined the inter-rater reliability and discriminant and concurrent validity of the behavioral checklist used. Methods: The non-nociceptive procedure involved calling the patient and shaking his/her shoulder. The nociceptive procedure involved turning the patient. The frequency of behaviors was recorded using a behavioral checklist. Results: Patients with absence of movement, or stereotyped flexion or extension responses to a nociceptive stimulus displayed more behaviors during turning (median 5.5, range 0-14) than patients with localized responses (median 4, range 0-10) or able to self-report their pain (median 4, range 0-10). Face flushing, clenched teeth, clenched fist, and tremor were more frequent in patients with absence of movement, or stereotyped responses to a nociceptive stimulus. The reliability of the checklist was supported by a high intra-class correlation coefficient (0.77-0.92), and the internal consistency was acceptable in all three groups (KR 20, 0.71-0.85). Discriminant validity was supported as significantly more behaviors were observed during nociceptive stimulation than at rest. Concurrent validity was confirmed as checklist scores were correlated to the patients' self-reports of pain (r s = 0.53; 95 % CI 0.21-0.75). Conclusion: Brain-injured patients reacted significantly more during a nociceptive stimulus and the number of observed behaviors was higher in patients with a stereotyped response. 2014 Journal Article http://hdl.handle.net/20.500.11937/17587 10.1007/s00134-014-3380-y Springer Verlag restricted |
| spellingShingle | Roulin, M. Ramelet, Anne-Sylvie Behavioral changes in brain-injured critical care adults with different levels of consciousness during nociceptive stimulation: An observational study |
| title | Behavioral changes in brain-injured critical care adults with different levels of consciousness during nociceptive stimulation: An observational study |
| title_full | Behavioral changes in brain-injured critical care adults with different levels of consciousness during nociceptive stimulation: An observational study |
| title_fullStr | Behavioral changes in brain-injured critical care adults with different levels of consciousness during nociceptive stimulation: An observational study |
| title_full_unstemmed | Behavioral changes in brain-injured critical care adults with different levels of consciousness during nociceptive stimulation: An observational study |
| title_short | Behavioral changes in brain-injured critical care adults with different levels of consciousness during nociceptive stimulation: An observational study |
| title_sort | behavioral changes in brain-injured critical care adults with different levels of consciousness during nociceptive stimulation: an observational study |
| url | http://hdl.handle.net/20.500.11937/17587 |