The Reliability of a Behavioural Pain Assessment in PDOC
Research type
Research Study
Full title
The Reliability of a Behavioural Pain Assessment in patients in Prolonged Disorders of Consciousness (PDOC).
IRAS ID
203983
Contact name
Aideen Steed
Contact email
Sponsor organisation
London North West Healthcare NHS Trust
Duration of Study in the UK
0 years, 4 months, 15 days
Research summary
A common concern for families and health professionals caring for patients in Prolonged Disorder of Consciousness (PDOC) is that they may be experiencing pain. As a result of severe brain injury, the patient is unable to consistently communicate. It is unclear to all if the patient is actually experiencing pain or is demonstrating reflex level behaviours in response to stimuli. Therefore, the development of sensitive, standardised tools to accurately assess responses that may be related to pain in the PDOC patient are essential to aid clinical and therapeutic management. Advocated by the Royal College of Physicians in 2013, the Behavioural Pain Assessment in PDOC (BPA in PDOC) has yet to be psychometrically evaluated. This study aims to evaluate the inter-rater reliability of the questionnaire (BPA in PDOC) and compare it with widely used pain questionnaire – the Nociception Coma Scale-Revised
This is a prospective study including patients admitted to a tertiary specialist neurology rehabilitation unit in the NHS, London, UK, for evaluation of PDOC. All patients are admitted to the unit for an assessment programme consisting of detailed clinical evaluation by a highly skilled MDT of therapists, doctors and nurses trained in the assessment and management of patients in PDOC. Care is first optimised through a 24 hour programme of postural management, including changes of position as appropriate (e.g. lying, sitting, standing). The BPA in PDOC and frequency of use proposed for the protocol is currently embedded as part of routine practice at the unit planned for the study. The assessment is one of observation during routine usual care/therapy tasks, rather than the provision of an intervention. Patients will be assessed by two expert therapists (rater A and rater B) to measure inter-rater agreement during routine therapy sessions. Sample size is anticipated to be 15-18 subjects over a 4-6month period.
REC name
South Central - Hampshire A Research Ethics Committee
REC reference
17/SC/0183
Date of REC Opinion
25 Apr 2017
REC opinion
Favourable Opinion