Family Members' Experiences with Observing Pain Behaviors Using the Critical-Care Pain Observation Tool.

Background: Current guidelines support family members' participation in care, but little is known regarding their potential contribution to pain assessment using validated behavioral pain scales.
Aims: This study aimed to describe family members' observations of pain behaviors with the Critical-Care Pain Observation Tool and their evaluation of the tool and its use, and to understand their experience and perceptions of their potential role in pain management in the intensive care unit.
Design: A mixed methods cross-sectional explanatory design was used.
Setting: A medical-surgical intensive care unit in Canada.
Participants/subjects: Family members were eligible if they had a loved one admitted in the intensive care unit who was unable to self-report.
Methods: Family members identified pain behaviors using the Critical-Care Pain Observation Tool after a brief training, completed a self-administered questionnaire, and participated in a follow-up individual interview regarding their experience and perceived potential role in pain management when their loved one is unable to self-report.
Results: Ten family members participated. A 15-minute training appeared sufficient for family members to be comfortable with observing pain behaviors included in the Critical-Care Pain Observation Tool. The tool allowed them to confirm their observations of pain behaviors, to focus more on the patient, and to advocate for better pain management.
Conclusions: Future research is needed to explore the views of more family members and to compare their Critical-Care Pain Observation Tool scores to the ones of nurses' for interrater reliability testing.
(Copyright © 2019 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)