The Critical Care Pain Observation Tool for Families (CPOT-Fam)

Background Patients in the intensive care unit (ICU) are often unable to communicate. Family caregivers could assist in pain assessment using a family-adapted version of the Critical Care Pain Observation Tool (CPOT-Fam).Aims We aimed to evaluate the feasibility, acceptability, and convergent validity (compared with nurses’ CPOT scores) of the CPOT-Fam for use by family caregivers to assess pain behaviors in ICU patients.Methods We collected simultaneous pain assessments from family caregivers (CPOT-Fam) and from nurses (CPOT) during periods of rest and standard care procedures in ICU patients. Feasibility was assessed by both the proportion of family caregivers who consented to participate and who completed the CPOT-Fam. Acceptability was assessed using surveys of the sentiments of family caregivers and nurses toward family involvement in pain assessment. Convergent validity was evaluated using Spearman’s rank correlation between CPOT-Fam and CPOT scores.Results Fifty-two family caregivers were approached to participate in this study, 43 (82.3%) consented, and all 43 (100%) completed the study. Most family caregivers (90.0%) and nurses (81.4%) reported that families have a valuable role in pain assessment in the ICU. Correlation between CPOT-Fam and CPOT scores (43 paired assessments; [95% confidence intervals]) at rest was ρ = 0.419 [0.127, 0.644], and during standard care procedures (n = 12 paired assessments) was ρ = 0.743 [0.276, 0.926].Conclusions The CPOT-Fam appears to be a feasible and acceptable tool for family caregivers to assess pain in ICU patients. Clinical evaluation of CPOT-Fam reliability and validity is warranted.