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Comparison of Pain Behaviors of Brain-Injured Patients Based on Clinical Characteristics: A Cross-Sectional Study
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Melika Kaviani   , Hamid Sharif- Nia , Saeed Barzegari , Roghieh Nazari * |
| Department of Nursing, Amol School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran , rnazari@mazums.ac.ir |
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Abstract: (163 Views) |
Background & aim: Most of the brain-injured patients hospitalized in the Intensive Care Unit (ICU) are not able to report their pain. In order to assess their pain, the CPOT-Neuro has been developed. Actually they may indicate different pain behaviors according to clinical conditions. Therefore, this study was conducted with the aim of comparing pain behaviors in brain-injured patients based on their clinical characteristics.
Methods: This cross-sectional study was carried out on 132 brain-injured patients in Amol city, Iran who were enrolled in the study from December 2023 to March 2024. Data were collected using a demographic checklist and a Critical-Care Pain Observation Tool Neuro (CPOT-Neuro). Patients' behaviors were evaluated before, during and after change position (nociceptive procedure).
Results: According to the frequency of pain behaviors observed during nociceptive procedure, a total of 105 patients indicated changes in facial expression, 13 patients in autonomic response, 88 patients in body movements, 46 patients in vocalization/ventilator tolerance and 31 patients indicated changes in muscle rigidity. By comparing the frequency of these behaviors during nociceptive procedure based on clinical characteristics, the chance of observing body movements during nociceptive procedure in non-traumatic patients was 60% lower than in traumatic patients (P<0.05). The probability of observing the autonomic response, vocalization/ ventilator tolerance and muscle rigidity during the nociceptive procedure decreased with the improvement of the level of consciousness (P<0.05). In addition, the chance of observing the autonomic response, body movements, vocalization/ ventilator tolerance and muscle rigidity during nociceptive procedure increased with the change in patients' sedation (P<0.05). The possibility of observing a change in muscle rigidity during nociceptive procedure in patients under mechanical ventilation was 74% lower than in patients without mechanical ventilation (P<0.05).
Conclusion: This study showed that pain behaviors in brain-injured patients were different based on the type of brain-injury, the level of consciousness, the level of sedation and the way of breathing. These findings highlight consideration of clinical characteristics when evaluating and managing pain in these patients.
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| Keywords: Brain Injury, Pain, Behaviors, Pain Measurement, Intensive Care Units. |
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Full-Text [PDF 1156 kb]
(75 Downloads)
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Type of Study: Research |
Subject:
Special
Received: 2024/07/6 | Accepted: 2024/07/29 | Published: 2024/11/2
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