{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:50:32Z","timestamp":1772160632694,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI20\/00431"],"award-info":[{"award-number":["PI20\/00431"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To adapt and validate the Behavioural Indicators of Pain Scale (ESCID) for use in critically ill patients with acquired brain injury and artificial airway who are unable to self\u2010report (ESCID\u2010DC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multicentre, prospective, observational validation study of the Behavioural Indicators of Pain Scale\u2010Brain Injury (ESCID\u2010DC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study will be carried out in three phases, as follows: (1) Content development and evaluation of content validity by a group of experts (Delphi technique). Face validity will be assessed through a pilot study; (2) multicentre validation study of the new scale (ESCID\u2010DC) in a large sample of patients (\u2265\u2009300) at 17 hospitals in Spain. Two blinded observers at each centre will assess painful behaviours using the ESCID\u2010DC and a reference scale, the NCS\u2010R\u2010I (Nociception Coma Scale\u2010Revised\u2014adapted for Intubated patients). Pain will be assessed at three time points: 5\u2009min before, during and 15\u2009min after the performance of painful and non\u2010painful procedures; (3) the psychometric evaluation of the scale will consist of a reliability analysis, a validity analysis (construct, convergent and discriminant), and a sensitivity to change analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The ESCID\u2010DC scale will provide specific, adapted behavioural indicators to detect the presence of pain in this patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>Given the high prevalence of pain in critically ill patients, the availability of a new instrument to detect and monitor pain behaviours associated with routine ICU procedures will allow clinicians to reliably assess pain and implement preventive strategies in a highly vulnerable patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>The report of this study protocol followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines and Consensus\u2010based Standards for the selection of health Measurement Instruments (COSMIN) guidelines and standards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>This study did not receive any patient or public contributions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      The protocol is registered with\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      : NCT04898491, available at:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT04898491\">https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT04898491<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.16983","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T09:23:24Z","timestamp":1748337804000},"page":"5143-5150","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validity and Reliability of the Behavioural Indicators of Pain Scale Adapted to Patients With Acquired Brain Injury:\n                    <scp>ESCID<\/scp>\n                    \u2010\n                    <scp>DC<\/scp>\n                    Study Protocol"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1536-8660","authenticated-orcid":false,"given":"Candelas","family":"L\u00f3pez\u2010L\u00f3pez","sequence":"first","affiliation":[{"name":"Emergency and Trauma Intensive Care Unit Hospital Universitario 12 de OctubreMadrid  Madrid Spain"},{"name":"Care Research Group (InveCuid) Instituto de Investigaci\u00f3n Sanitaria 12 de Octubre University Hospital (imas12)  Madrid Spain"},{"name":"Faculty of Nursing, Physiotherapy and Podiatry Complutense University of Madrid  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7528-0890","authenticated-orcid":false,"given":"Ignacio","family":"Latorre\u2010Marco","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Hospital Universitario Puerta de Hierro Majadahonda  Madrid Spain"},{"name":"Nursing and Health Care Research Group 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