Cross-cultural adaptation and validation of the Indonesian version of the Critical-care Pain Observation Tool

Abstract

Objective: The Critical-care Pain Observation Tool (CPOT) is one of the most accurate methods for assessing pain in ICU patients with critical illness and/or a decreased level of consciousness (LOC). This study aimed to determine the validity and reliability of the Indonesian version of the CPOT. Methods: The English version of CPOT was translated into the Indonesian version following five steps: initial translation, synthesis of instrument translation results, back translation, validation of the instrument by an expert committee, and testing of the Indonesian instrument. Between September and December 2022, a total of 52 ICU patients from four hospitals in Indonesia were evaluated for pain at rest, during body-turning procedure, and 15 minutes after the procedure using the CPOT. The researcher used the verbal Faces Pain Thermometer (FPT) instrument as a gold standard to assess the CPOT’s criteria validity. Validity assessments included content and criterion validity. Reliability was evaluated using Cronbach’s α coefficient and interrater reliability. Results: Higher CPOT scores were found during the body-turning procedure than at rest and after the procedure. The instrument’s item-content validity index (I-CVI) ranged from 0.75 to 1.00, and the overall instrument’s average scale-level content validity index (S-CVI/Ave) was 0.93. The statistical analysis revealed a positive correlation (r) between the CPOT and the patient’s FPT scores (0.877–0.983, P < 0.01). The significant agreement amongst raters (κ) revealed the inter-rater reliability of the CPOT (0.739–0.834, P < 0.01). Conclusion: The Indonesian version of the CPOT has been proven valid and reliable in assessing pain in patients with critical illness and/or decreased LOC.

Keywords

• Critical care
• Pain assessment
• Patients
• Reliability
• Validity