{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:28:01Z","timestamp":1791239281141,"version":"4.1.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T00:00:00Z","timestamp":1709164800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T00:00:00Z","timestamp":1709164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008349","name":"Universit\u00e4t Duisburg-Essen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008349","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The evaluation of pain in patients, unable of oral communication, often relies on behavioral assessment. However, some critically ill patients, while non-verbal, are awake and have some potential for self-reporting. The objective was to compare the results of a behavioral pain assessment with self-reporting in awake, non-verbal, critically ill patients unable to use low-tech augmentative and alternative communication tools.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Prospective cohort study of intubated or tracheotomized adult, ventilated patients with a RASS (Richmond Agitation Sedation Scale) of -1 to +\u20091 and inadequate non-verbal communication skills in a surgical intensive care unit of a tertiary care university hospital. For pain assessment, the Behavioral Pain Scale (BPS) was used. Self-reporting of pain was achieved by using an eye tracking device to evaluate the Numeric Rating Scale (NRS) and the pain\/discomfort item of the EuroQol EQ-5D-5\u00a0L (EQ-Pain). All measurements were taken at rest.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Data was collected from 75 patients. Neither the NRS nor the EQ-Pain (<jats:italic>r<\/jats:italic>\u2009&lt;\u2009.15) correlated with the BPS. However, NRS and EQ-Pain were significantly correlated (<jats:italic>r<\/jats:italic>\u2009=\u2009.78, <jats:italic>p<\/jats:italic>\u2009=\u2009&lt;\u20090.001), indicating the reliability of the self-reporting by these patients. Neither the duration of intubation\/tracheostomy, nor cause for ICU treatment, nor BPS subcategories had an influence on these results.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Behavioral pain assessment tools in non-verbal patients who are awake and not in delirium appear unreliable in estimating pain during rest. Before a behavioral assessment tool such as the BPS is used, the application of high-tech AACs should be strongly considered.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>German Clinical Trials Register, Registration number: DRKS00021233. Registered 23 April 2020 - Retrospectively registered, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/drks.de\/search\/en\/trial\/DRKS00021233\">https:\/\/drks.de\/search\/en\/trial\/DRKS00021233<\/jats:ext-link>.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12871-024-02472-2","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T06:01:55Z","timestamp":1709186515000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Behavioral pain scale may not be reliable in awake non-verbal intensive care patients: a case control study"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5291-0853","authenticated-orcid":false,"given":"Christian","family":"Waydhas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Ull","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Cruciger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Hamsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Schildhauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Gaschler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Weckwerth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,29]]},"reference":[{"key":"2472_CR1","doi-asserted-by":"publisher","first-page":"e825","DOI":"10.1097\/CCM.0000000000003299","volume":"46","author":"JW Devlin","year":"2018","unstructured":"Devlin JW, Skrobik Y, Gelinas C, Needham DM, Slooter AJC, Pandharipande PP, et al. 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It was approved by the local ethics committee (Ruhr-University Bochum, Germany, Grant Number of Approval 18-6620-BR) and registered at the German Clinical Trials Register Identifier (DRKS00021233) on 23\/04\/2020. Informed consent was obtained by all patients, if possible, via head nodding, blinking, or the patients\u2019 legal representatives. If necessary, appropriate consent from patients without family support was confirmed by persons unrelated to the investigation. This study adheres to the \u201cStrengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement\u201d. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during this research.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"84"}}