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Psychometric Properties of Pain Scales in Inpatient Settings: An Umbrella Review

ABSTRACT

Aims

To identify the pain assessment scales with the best psychometric properties to be used by nurses in an inpatient setting.

Design

Umbrella review.

Methods

A comprehensive search of four databases was conducted for systematic reviews published from July 2013 to November 2024, focusing on psychometric properties of pain scales used in inpatient settings. Inclusion criteria required scales to assess subjective or behavioural pain and be nurse-administered, while reviews without detailed psychometric data were excluded. Screening, quality appraisal (JBI checklist), and data extraction were performed independently by two researchers. Data synthesis combined qualitative and quantitative approaches, with psychometric properties evaluated using the COSMIN checklist. The study was reported in accordance with the Preferred Reporting Items for Overviews of Reviews (PRIOR) statement.

Results

Seventeen articles met the inclusion criteria, identifying 41 scales used across various patient populations, including critical care, paediatric, postoperative, cancer, cerebral palsy, disorders of consciousness, low back and neck pain, stroke and verbal communication disorders. The Paediatric Pain Profile, the Breakthrough Pain Assessment Tool and the Questionnaire on Pain caused by Spasticity demonstrated adequate psychometric properties, although the positive findings for the latter two should be confirmed by at least one additional study. Most of the scales (n = 36) require further studies to validate their use in clinical practice. For two scales, their clinical use remains questionable.

Conclusion

The Paediatric Pain Profile, the Breakthrough Pain Assessment Tool, and the Questionnaire on Pain caused by Spasticity can be recommended for use. Unidimensional scales should complement, rather than replace, multidimensional scales to ensure a comprehensive pain assessment. Standardising documentation with validated scales enhances clinical decision-making, care quality, research usability, and reduces documentation burden.

Validity and Reliability of the Self‐Care of Chronic Illness Inventory in Patients Living With Inflammatory Bowel Disease

ABSTRACT

Aim

To test the psychometric properties of the Self-Care of Chronic Illness Inventory (SC-CII) in patients living with inflammatory bowel disease (IBD).

Design

A cross-sectional, multicenter study.

Methods

A total of 452 IBD patients were recruited from nine centres across Italy. Participants completed the SC-CII, the Self-Care Self-Efficacy Scale (SCSES), and a sociodemographic questionnaire. Structural validity was assessed using confirmatory factor analysis (CFA). Reliability was evaluated with Cronbach's alpha and McDonald's Omega. Construct validity was determined through correlations between SC-CII and SCSES scores.

Results

CFA confirmed the SC-CII's structural validity, demonstrating its multidimensional self-care maintenance, self-care monitoring, and self-care management structure. Reliability scores were satisfactory, with robust internal consistency. Significant positive correlations between SC-CII and SCSES scores confirmed its construct validity.

Conclusion

The SC-CII is a valid and reliable tool for assessing self-care behaviours in IBD patients. Its application in clinical and research settings can facilitate the evaluation of self-care practices, supporting the development of targeted interventions to improve patient outcomes.

Implications for the Profession and/or Patient Care

The SC-CII helps identify self-care deficits in IBD patients, enabling tailored interventions for better patient-centred care.

Impact

The study addressed the need for validated tools to assess self-care in IBD patients, crucial for managing conditions like IBD. The SC-CII proved valid and reliable, with CFA confirming its structure and correlations with self-efficacy supporting validity. It offers a robust tool to assess and promote self-care behaviours.

Reporting Method

The STROBE checklist ensured accurate and comprehensive reporting.

Patient or Public Contribution

IBD patients helped align the SC-CII with their experiences, ensuring its relevance.

Trial Registration

ClinicalTrials.gov identifier: NCT06015789

Association between health literacy and nursing care in hospital: A retrospective study

Abstract

Aims

To describe the health literacy (HL) levels of hospitalised patients and their relationship with nursing diagnoses (NDs), nursing interventions and nursing measures for clinical risks.

Design

Retrospective study.

Methods

The study was conducted from December 2020 to December 2021 in an Italian university hospital. From 146 wards, 1067 electronic nursing records were randomly selected. The Single-Item Literacy Screener was used to measure HL. Measures for clinical risks were systematically assessed by nurses using Conley Index score, the Blaylock Risk Assessment Screening Score, Braden score, and the Barthel Index. A univariable linear regression model was used to assess the associations of HL with NDs.

Results

Patients with low HL reported a higher number of NDs, interventions and higher clinical risks. HL can be considered a predictor of complexity of care.

Conclusions

The inclusion of standardised terms in nursing records can describe the complexity of care and facilitate the predictive ability on hospital outcomes.

Implications for the profession and/or patient care

HL evaluation during the first 24 h. From hospital admission could help to intercept patients at risk of higher complexity of care. These results can guide the development of interventions to minimise needs after discharge.

Patient or Public Contribution

No patient or public contribution was required to design or undertake this research. Patients contributed only to the data collection.

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