FACIAL EXPRESSION AS AN INDICATOR OF PAIN IN CRITICALLY ILL INTUBATED ADULTS DURING ENDOTRACHEAL SUCTIONING.
Background: Facial expression is often used to evaluate pain in noncommunicative critically ill patients. Objectives: To describe facial behavior during endotracheal suctioning, determine facial behaviors that characterize the pain response, and describe the effect of patient factors on facial behav...
| Publicado en: | American Journal of Critical Care Vol. 22; no. 5; pp. 412 - 423 |
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| Autores principales: | , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
American Association of Critical-Care Nurses
Sep2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107972552&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107972552 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10623264 44L jtl: American Journal of Critical Care issn: 10623264 maglogo: N pubinfo: dt: Sep2013 vid: 22 iid: 5 pid: 2559 pub: American Association of Critical-Care Nurses place: Alisa Veijo, California artinfo: ui: 107972552 90294693 10.4037/ajcc2013705 NLM23996421 107972552 ppf: 412 ppct: 11 formats: fmt: @attributes: type: P tig: atl: FACIAL EXPRESSION AS AN INDICATOR OF PAIN IN CRITICALLY ILL INTUBATED ADULTS DURING ENDOTRACHEAL SUCTIONING. aug: au: Rahu, Mamoona Arif Grap, Mary Jo Cohn, Jeffrey F. Munro, Cindy L. Lyon, Debra E. Sessler, Curtis N. affil: Clinical Nurse Specialist in Critical Care, School of Nursing, Virginia Commonwealth University, Richmond, VA sug: subj: Pain Symptoms Intubation, Intratracheal Suctioning, Endotracheal Facial Expression Critically Ill Patients Ventilator Patients Pain Measurement Human Facial Expression Evaluation Videorecording Intensive Care Units Virginia Record Review Medical Records Sedation Evaluation Interrater Reliability Descriptive Statistics Wilcoxon Signed Rank Test Spearman's Rank Correlation Coefficient Multivariate Statistics Male Female Adult Middle Age Aged Aged, 80 and Over Facial Expression Classification Funding Source APACHE (Acute Physiology and Chronic Health Evaluation) Clinical Assessment Tools Scales Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Background: Facial expression is often used to evaluate pain in noncommunicative critically ill patients. Objectives: To describe facial behavior during endotracheal suctioning, determine facial behaviors that characterize the pain response, and describe the effect of patient factors on facial behavior during pain response. Methods:Fifty noncommunicative patients receiving mechanical ventilation were video recorded during 2 phases (rest and endotracheal suctioning). Pain ratings were gathered by using the Behavioral Pain Scale. Facial behaviors were coded by using the Facial Action Coding System for 30 seconds for each phase. Results: Fourteen facial actions were associated more with endotracheal suctioning than with rest (z=5.78; P<.001). The sum of intensity of the 14 actions correlated with total mean scores on the Behavioral Pain Scale (p = 0.71; P<.001) and with the facial expression component of the scale (p = 0.67; P<.001) during suctioning. In stepwise multivariate analysis, 5 pain-relevant facial behaviors (brow raiser, brow lower, nose wrinkling, head turned right, and head turned up) accounted for 71% of the variance (adjusted R2 = 0.682; P<.001) in pain response. The sum of intensity of the 5 actions correlated with total mean scores on the behavioral scale (p = 0.72; P<.001) and with the facial expression component of that scale (p = 0.61; P<.001) during suctioning. Patient factors had no association with pain intensity scores. Conclusions: Upper facial expressions are most frequently activated during pain response in noncommunicative critically ill patients and might be a valid alternative to self-report ratings. (American Journal of Critical Care. 2013;22:412-422) pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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