Pain assessment in the multilingual intensive care environment in Saudi Arabia

Abstract

This research compared the novel image-based Behaviour Pain Assessment Tool to the widely used text-based Behavioural Pain Scale for assessing pain in nonverbal, intubated patients in a multi-culturally staffed intensive care unit. Utilising sequential mixed-methods design, study findings demonstrated that the image-based tool showed good inter-rater reliability, sensitivity, specificity and discriminant validity. Substituting text descriptors of pain with images of painful facial expressions assessing pain behaviour was preferred by multilingual nurses. While both tools identified the presence of pain, neither adequately quantified pain severity. These findings provide evidence for culturally responsive, reliable pain assessment practices in diverse critical care settings.