INSTRUMEN PENGKAJIAN NYERI PADA PASIEN KRITIS DI INTENSIVE CARE UNIT (ICU): STUDI LITERATUR
Abstract
Pendahuluan: Mayoritas pasien kritis di ICU mengalami nyeri selama proses perawatan. Nyeri merupakan hal
yang bersifat subjektif sehingga yang dilaporkan oleh pasien menjadi pengkajian dan evaluasi yang paling baik.
Akan tetapi, sebagian besar pasien kritis di ICU terintubasi, menggunakan ventilasi mekanik ataupun mengalami
penurunan kesadaran. Walaupun demikian, nyeri harus tetap dikaji dan dievaluasi untuk menentukan manajemen
nyeri pada pasien kritis di ICU. Hal tersebut membutuhkan instrumen pengkajian nyeri yang praktis, objektif dan
relevan dengan kondisi pasien di ICU.
Metode: Penyusunan studi literatur ini menggunakan jurnal-jurnal yang relevan dari mesin pencari seperti
proquest.com, sciencedirect.com dan scholar.google.com dengan kata kunci pain, assessment tool, critical care.
Pembahasan: Terdapat empat instrumen pengkajian nyeri pada pasien kritis di ICU yang telah teruji yaitu
Behavioral Pain Scale (BPS), Critical Care Pain Observation Tool (CPOT), Non-verbal Pain Scale (NVPS) dan
Pain Assessment and Intervention Notation (PAIN). Keempat instrumen pengkajian nyeri tersebut memiliki
kelemahan dan kelebihannya masing-masing. Diantara keempat instrumen pengkajian nyeri tersebut, BPS dan
CPOT merupakan instrumen yang objektif, praktis dan relevan serta akurat sesuai karakteristik pasien kritis di
ICU. Kedua instrumen tersebut memiliki nilai reliabilitas dan validitas yang baik yaitu BPS: 0,72;3,9-6,8(p<0,001)
dan CPOT: 0,71;0,26-0,56(p<0,001) dibandingkan dengan NVPS: 0,59;0,19-0,44(p<0,001) dan PAIN: p<0,05.
Simpulan: BPS dan CPOT adalah instrumen yang paling objektif, praktis, dan relevan digunakan untuk mengkaji
nyeri pada pasien kritis di ICU karena dapat mengkaji nyeri pada pasien kritis di ICU dengan penurunan
kesadaran.
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