Nurses’ Perceptions on the Use of Thai Version of the Critical-Care Pain Observation Tool-Neuro (Th-CPOT-Neuro) in Thai Neurosurgical Patients: A Qualitative Study
Article Sidebar
Main Article Content
Abstract
Purpose: To explore neurosurgery nurses’ perceptions regarding the use of the Critical Care Pain Observation Tool Neuro Thai version (Th-CPOT-Neuro).
Design: A qualitative descriptive study.
Methods: A semi-structured interview approach was used with open-ended questions. Ten registered nurses who had been trained and had bedside experiences using the Th-CPOT-Neuro were recruited, and data saturation was achieved. The interviews lasted for 20-40 minutes. Qualitative content analysis was employed to analyze the data and derive meaningful findings.
Main findings: Nurses’ perceptions on the use of the Th-CPOT-Neuro, as derived from the data analysis, were categorized into three major themes and six sub-themes. The major themes consisted of: 1) acceptability, with two sub-themes — usability/high satisfaction and improper handling for exceptional conditions; 2) feasibility, with two sub-themes — efficient training and conditional restriction; and 3) clinical utility, with two sub-themes — worth implementing and lack of engagement. Some participants suggested revising the scoring system to enable accurate calculation of the total score when an individual domain is missing, thereby enhancing its validity. They emphasized the importance of implementing a comprehensive interdisciplinary training program for healthcare professionals to ensure accurate tool application. They agreed to adopt the Th-CPOT-Neuro into their daily practice instead of the standard CPOT to optimize pain assessment in neurosurgical patients.
Conclusions and recommendations: The Th-CPOT-Neuro containing a unique pain-related behavior is suitable, useful, and easy-to-use for the assessment of pain in neurosurgical patients both in intensive care unit and in other care settings. Its implementation into daily practice in the Thai hospital context with a comprehensive interdisciplinary training program could enhance an optimal pain assessment in neurosurgical patients.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright Notice: Nursing Science Journal of Thailand has exclusive rights to publish and distribute the manuscript and all contents therein. Without the journal’s permission, the dissemination of the manuscript in another journal or online, and the reproduction of the manuscript for non-educational purpose are prohibited.
Disclaimer: The opinion expressed and figures provided in this journal, NSJT, are the sole responsibility of the authors. The editorial board bears no responsibility in this regard.
References
Herr K, Anderson AR, Arbour C, Coyne PJ, Ely E, Gélinas C, et al. Pain assessment in the patient unable to self-report: clinical practice recommendations in support of the ASPMN 2024 position statement. Pain Manag Nurs. 2024;25(6):551-68. doi: 10.1016/j.pmn.2024.09.010.
Gélinas C, Bérubé M, Puntillo KA, Boitor M, Richard-Lalonde M, Bernard F, et al. Validation of the Critical-Care Pain Observation Tool-Neuro in brain-injured adults in the intensive care unit: a prospective cohort study. Crit Care. 2021;25(1):142. doi: 10.1186/s13054-021-03561-1.
Komlakh K, Hatefi M, Soltany B. Comparison of pain score in patients with brain disorders using care pain observation tool (CPOT) and nonverbal pain scale (NVPS). Arch Neurosci. 2022;9(4):e123099. doi: 10.5812/ans-123099.
Nguyen V, Richard-Lalonde M, Gélinas C. Interrater agreement between bedside and video raters using the CPOT-Neuro for pain assessment in critically ill patients with a brain injury. Nurs Rep. 2024;14(1):212-9. doi: 10.3390/nursrep14010017.
Richard-Lalonde M, Bérubé M, Williams V, Bernard F, Darina Tsoller, Gélinas C. Nurses’ evaluations of the feasibility and clinical utility of the use of the Critical-Care Pain Observation Tool-Neuro in critically ill brain-injured patients. Science of Nursing and Health Practices. 2019;2(2):1-18. doi: 10.7202/1076466ar.
Prasertsri N, Leaungsomnapa Y, Katekham S. Pain assessment in brain-injured patients in the intensive care unit. Nursing Journal of The Ministry of Public Health. 2023;33(1):14-22. (in Thai).
Chaleewong N, Chaiviboontham S, Christensen M. Knowledge, attitudes, and perceived barriers regarding pain assessment and management among Thai critical care nurses: a cross-sectional study. Intensive Crit Care Nurs. 2024;84:103764. doi: 10.1016/j.iccn.2024.103764.
Thikom N, Thongsri R, Wongcharoenkit P, Khruamingmongkhon P, Wongtangman K. Incidence of inadequate pain treatment among ventilated, critically ill surgical patients in a Thai population. Pain Manag Nurs. 2021;22(3):336-42. doi: 10.1016/j.pmn.2020.09.010.
World Health Organization (WHO). Process of translation and adaptation of instruments [Internet]. Geneva: WHO; 2018 [cited 2025 Aug 20]. Available from: http://www.who.int/substance_abuse/research_tools/translation/en/
Bilalee S, Maneewat K, Nimmaanrat S. The report of development and validation of a Thai version of the Critical-Care Pain Observation Tool-Neuro (Th-CPOT-Neuro) in Thai neurosurgical patients unable to self-report [research report]. Songkhla: Faculty of Medicine, Prince of Songkla University; 2025. 27 p. (in Thai).
Holloway I, Galvin K. Qualitative research in nursing and healthcare. 5th ed. Hoboken, NJ: John Wiley & Sons; 2024. 344 p.
Ayton D, Tsindos T, Berkovic D. Qualitative research: a practical guide for health and social care researchers and practitioners. Clayton, Victoria: Monash University; 2023. 45 p.
Doyle L, McCabe C, Keogh B, Brady A, McCann M. An overview of the qualitative descriptive design within nursing research. J Res Nurs. 2020;25(5):443-55. doi: 10.1177/1744987119880234.
Villamin P, Lopez V, Thapa DK, Cleary M. A worked example of qualitative descriptive design: a step‐by‐step guide for novice and early career researchers. J Adv Nurs. 2025;81(8):5181-95. doi: 10.1111/jan.16481.
Vears DF, Gillam L. Inductive content analysis: a guide for beginning qualitative researchers. Focus on Health Professional Education: A Multi‑Professional Journal. 2022;23(1):111-27. doi: 10.11157/fohpe.v23i1.544.
Kodagoda Gamage MW, Pu L, Moyle W, Barton M, Todorovic M. The effectiveness of educational interventions in enhancing health professionals’ and students’ pain assessment for people living with dementia: a systematic review. Nurse Educ Today. 2025;148:106606. doi: 10.1016/j.nedt.2025.106606.
Kibiswa NK. Directed qualitative content analysis (DQlCA): a tool for conflict analysis. Qual Rep. 2019;24(8):2059-79. doi: 10.46743/2160-3715/2019.3778.
Phongphanngam S, Lach HW. Cross-cultural instrument translation and adaptation: challenges and strategies. Pac Rim Int J Nurs Res Thail. 2019;23(2):170-9.
Alomari H, Allobaney N, Swallmeh E, Macaaly R, Al-Husban R. Effect of an educational program on nurses’ level of knowledge about pain assessment and management: a quasi experimental. Research Square. 2024. doi: 10.21203/rs.3.rs-5231832/v1.
Siddiqui AS, Zehra T, Ahmed A, Rehman A, Ahmed U, Afshan G. Enhancing nursing staff clinical skills of pain assessment: impact of the educational course. International Journal of Nursing Education. 2024;16(3):13-23. doi: 10.37506/jdp7j820.
Tata TK, Ohene LA, Dzansi GA, Aziato L. Factors influencing nurses’ pain assessment and management of road traffic casualties: a qualitative study at a military hospital in Ghana. BMC Emerg Med. 2024;24(1):100. doi: 10.1186/s12873-024-01016-8.
Xu X, Chen H, Xu J, Zhang Y, Gong R, Hu X. The status and challenges of pain assessment in hospitalized patients: a cross-sectional study. Pain Manag Nurs. 2024;26(2):e124-30. doi: 10.1016/j.pmn.2024.11.003.
