The primary objective of this study was to describe the frequency of behaviors observed during rest, a non-nociceptive procedure, and a nociceptive procedure in brain-injured intensive care unit ICU patients with different levels of consciousness LOC.
Second, it examined the inter-rater reliability and discriminant and concurrent validity of the behavioral checklist used. The nociceptive procedure involved turning the patient. The frequency of behaviors was recorded using a behavioral checklist.
Patients with absence of movement, or stereotyped flexion or extension responses to a nociceptive stimulus displayed more behaviors during turning median 5. Face flushing, clenched teeth, clenched fist, and tremor were more frequent in patients with absence of movement, or stereotyped responses to a nociceptive stimulus.
The reliability of the checklist was supported by a high intra-class correlation coefficient 0. Discriminant validity was supported as significantly more behaviors were observed during nociceptive stimulation than at rest. Brain-injured patients reacted significantly more during a nociceptive stimulus and the number of observed behaviors was higher in patients with a stereotyped response.
In brain-injured patients, pain is a major concern as it can alter cerebral perfusion and therefore increase the risk of brain damage [ 2 ]. In order to provide adequate pain relief, sedatives and analgesics must be administered; however, these drugs can mask clinical signs of neurological complications [ 2 , 3 ]. Therefore, it is essential to accurately assess pain in order to achieve adequate pain relief without jeopardizing neurological assessment.
