eISSN 2097-6046
ISSN 2096-7446
CN 10-1655/R
Responsible Institution：China Association for Science and Technology
Sponsor：Chinese Nursing Association
中华急危重症护理杂志

Chinese Journal of Emergency and Critical Care Nursing >

2026 , Vol. 7 >Issue 3: 337 - 343

DOI: https://doi.org/10.3761/j.issn.2096-7446.2026.03.016

Quality and Safety

Cross-cultural adaptation and psychometric validation of the Critical-Care Pain Observation Tool for Families

  • XIAO Yanping ,
  • CHEN Xiangping ,
  • LAO Yuewen ,
  • YU Wei ,
  • LIU Peiqi ,
  • ZHU Bingyan ,
  • HU Xinru
Expand
  • Nursing Department， Sir Run Run Shaw Hospital，Zhejiang University School of Medicine， Hangzhou 310000， China

Received date: 2025-04-03

  Online published: 2026-03-02

Supported by

Zhejiang Medical Research Project(2024KY1101)

Fold

Abstract

Objective To translate and culturally adapt the Critical-Care Pain Observation Tool for Families （CPOT-Fam） and validate its psychometric properties among family members of ICU patients.Methods The CPOT-Fam was translated using the Brislin translation model，including forward and back-translation，followed by review by the original authors，cultural adaptation，and pilot testing to finalize the Chinese version. From January to March 2025，100 family members of adult patients in a general ICU of a tertiary hospital in Zhejiang Province were recruited via convenience sampling to validate the scale’s reliability and validity.Results The internal consistency reliability Cronbach’s α coefficient for the Chinese version of CPOT-Fam was 0.786. The overall agreement between family members（CPOT-Fam） and nurses（CPOT） for pain assessment was substantial（κ= 0.681，95%CI：0.541-0.786）. Among individual items，facial expression showed the highest agreement（κ=0.814），while body movements had the lowest（κ=0.601）. The scale-level content validity index（S-CVI） was 0.99，with item-level CVI（I-CVI） ranging from 0.88 to 1.00. The criterion validity correlation coefficient was 0.783（P<0.001）.Conclusion The Chinese version of CPOT-Fam exhibits satisfactory reliability and validity，serving as an effective tool for family members to participate in pain assessment for ICU patients in a Chinese cultural context.

Key words： Critical Care; Pain Assessment; Family Members; Scale Translation

Cite this article

XIAO Yanping , CHEN Xiangping , LAO Yuewen , YU Wei , LIU Peiqi , ZHU Bingyan , HU Xinru . Cross-cultural adaptation and psychometric validation of the Critical-Care Pain Observation Tool for Families[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026 , 7(3) : 337 -343 . DOI: 10.3761/j.issn.2096-7446.2026.03.016

References

[1] Raja SN, Carr DB, Cohen M, et al. The revised International Asso-ciation for the Study of Pain definition of pain:concepts,challenges,and compromises[J]. Pain, 2020, 161(9):1976-1982.
[2] Guo NN, Wang HL, Zhao MY, et al. Management of procedural pain in the intensive care unit[J]. World J Clin Cases, 2022, 10(5):1473-1484.
[3] Afenigus AD. Evaluating pain in non-verbal critical care pa-tients:a narrative review of the critical care pain observation tool and Its clinical applications[J]. Front Pain Res, 2024, 5:1481085.
[4] 刘敏君, 祁海鸥, 薛子豪, 等. 危重症术后患者ICU过渡期疼痛管理的研究进展[J]. 中华急危重症护理杂志, 2021, 2(2):162-166.
  Liu MJ, Qi HO, Xue ZH, et al. Review on pain management in postoperative critical patients during ICU transition[J]. Chin J Emerg Crit Care Nurs, 2021, 2(2):162-166.
[5] 尹金瑜, 陈香萍, 劳月文, 等. ICU转出患者慢性疼痛评估与预测工具的研究进展及启示[J]. 中华急危重症护理杂志, 2024, 5(10):926-931.
  Yin JY, Chen XP, Lao YW, et al. Research progress and enlightenment of evaluation and prediction tools for chronic ICU-related pain[J]. Chin J Emerg Crit Care Nurs, 2024, 5(10):926-931.
[6] Herr K, Anderson AR, Arbour C, et al. Pain assessment in the patient unable to self-report:clinical practice recommendations in support of the ASPMN 2024 position statement[J]. Pain Manag Nurs, 2024, 25(6):551-568..
[7] 张依文, 黄维肖. 我国ICU成人危重症患者疼痛评估工具的研究进展[J]. 科技资讯, 2020, 18(31):232-235.
  Zhang YW, Huang WX. Research progress of pain assessment tools for adult critical patients in ICU in China[J]. Sci Tech-nol Inf, 2020, 18(31):232-235.
[8] 李青栋, 万献尧, 谷春梅, 等. 中文版ICU患者疼痛观察工具在机械通气患者应用的信度与效度[J]. 中华内科杂志, 2012, 51(8):642-643.
  Li QD, Wan XY, Gu CM, et al. Reliability and validity of Chinese version of pain observation tool for ICU patients in mechanical ventilation patients[J]. Chin J Intern Med, 2012, 51(8):642-643.
[9] 陈杰, 杨晓红, 路潜, 等. 中文版重症监护疼痛观察工具在非气管插管患者中应用的信效度研究[J]. 中华护理杂志, 2015, 50(9):1132-1136.
  Chen J, Yang XH, Lu Q, et al. Reliability and validity of Chinese version of the Critical-Care Pain Observation Tool in non-intubated ICU patients[J]. Chin J Nurs, 2015, 50(9):1132-1136.
[10] Fiest KM, Krewulak KD, Wesley Ely E, et al. Partnering with family members to detect delirium in critically ill patients[J]. Crit Care Med, 2020, 48(7):954-961.
[11] Richard-Lalonde M, Boitor M, Mohand-Sa?d S, et al. Family mem-bers’ perceptions of pain behaviors and pain management of adult patients unable to self-report in the intensive care unit:a qualitative descriptive study[J]. Can J Pain, 2018, 2(1):315-323.
[12] Vanderbyl BL, Gélinas C. Family perspectives of traumatically brain-injured patient pain behaviors in the intensive care unit[J]. Pain Manag Nurs, 2017, 18(4):202-213.
[13] Shahid A, Sept BG, Owen VS, et al. Preliminary clinical testing to inform development of the Critical Care Pain Observation Tool for Families(CPOT-Fam)[J]. Can J Pain, 2023, 7(2):2235399.
[14] Shahid A, Sept BG, Longmore S, et al. Development and prec-linical testing of the critical care pain observation tool for family caregiver use(CPOT-Fam)[J]. Health Sci Rep, 2022, 6(1):e986.
[15] Gélinas C, Fillion L, Puntillo KA, et al. Validation of the criti-cal-care pain observation tool in adult patients[J]. Am J Crit Care, 2006, 15(4):420-427.
[16] 李峥, 刘宇. 护理学研究方法[M]. 2版. 北京: 人民卫生出版社, 2018.
  Li Z, Liu Y. Nursing research methods[M]. 2nd ed. Beijing: People’s Medical Publishing House, 2018.
[17] Sousa VD, Rojjanasrirat W. Translation,adaptation and valida-tion of instruments or scales for use in cross-cultural health care research:a clear and user-friendly guideline[J]. J Eval Clin Pract, 2011, 17(2):268-274.
[18] Barr J, Fraser GL, Puntillo K, et al. Clinical practice guide-lines for the management of pain,agitation,and delirium in adult patients in the intensive care unit[J]. Crit Care Med, 2013, 41(1):263-306.
[19] 吴明隆. 问卷统计分析实务.SPSS操作与应用[M]. 重庆: 重庆大学出版社, 2010.
  Wu ML. Practice of questionnaire statistical analysis:SPSS operation and application[M]. Chongqing: Chongqing Universi-ty Press, 2010.
[20] 万丽, 赵晴, 陈军, 等. 疼痛评估量表应用的中国专家共识(2020版)[J]. 中华疼痛学杂志, 2020, 16(3):177-187.
  Wan L, Zhao Q, Chen J, et al. Expert consensus on the application of pain evaluation questionnaires in China(2020)[J]. Chin J Painology, 2020, 16(3):177-187.
Options
Outlines

/

〈 〉