Development and Validation of a Thai Version of the Critical-Care Pain Observation Tool-Neuro (Th-CPOT-Neuro) in Thai Neurosurgical Patients Unable to Self-Report

Objective: This study aimed to translate the English version of the Critical Care Pain Observation Tool-Neuro (CPOT-Neuro) to a simplified Thai version (Th-CPOT-Neuro) and to validate and investigate the reliability of the Thai version. Material and Methods: The primary English version of the CPOT-Neuro proposed by Gélinas was used for reference. The Th-CPOT-Neuro was developed using forward translation and back translation methods proposed by the World Health Organization. Content validity of the Th-CPOT-Neuro was established using the content validity index (CVI) as appraised by three specialists. Discriminative validation of the Th-CPOT-Neuro was evaluated during painful and non-painful routine procedures. The Kappa coefficient was used to test the inter-rater reliability of the Th-CPOT-Neuro. Results: The scale-level CVI (S-CVI) of the Thai version of the CPOT-Neuro was 0.82, which is above the lower limit of acceptability for the S-CVI (0.80). Inter-rater reliability of the Th-CPOT-Neuro scores was supported with intraclass correlation coefficients >0.86. Discriminative validation of the Th-CPOT-Neuro was supported with higher scores during painful procedures compared to baseline at rest, both before and at the peak opioid analgesic effect (p-value<0.01). Conclusion: The Th-CPOT-Neuro has good psychometric properties to assess pain in Thai neurosurgical patients unable to self-report. Implementation of the Th-CPOT-Neuro to assess pain in the local Thai context is therefore recommended.