• Clinical rehabilitation · Apr 2015

    A study of the reliability of the Nociception Coma Scale.

    • F Riganello, M D Cortese, F Arcuri, A Candelieri, F Guglielmino, G Dolce, W G Sannita, and C Schnakers.
    • Research in Advanced Neurorehabilitation, S. Anna Institute, Italy f.riganello@istitutosantanna.it.
    • Clin Rehabil. 2015 Apr 1;29(4):388-93.

    ObjectiveIn this study, we investigated the reliability of the Nociception Coma Scale which has recently been developed to assess nociception in non-communicative, severely brain-injured patients.DesignProspective cross-sequential study.SettingSemi-intensive care unit and long-term brain injury care.SubjectsForty-four patients diagnosed as being in a vegetative state (n=26) or in a minimally conscious state (n=18).InterventionsPatients were assessed by two experts (rater A and rater B) on two consecutive weeks to measure inter-rater agreement and test-retest reliability.Main MeasuresTotal scores and subscores of the Nociception Coma Scale.ResultsWe performed a total of 176 assessments. The inter-rater agreement was moderate for the total scores (k = 0.57) and fair to substantial for the subscores (0.33 ≤ k ≤ 0.62) on week 2. The test-retest reliability was substantial for the total scores (k = 0.66) and moderate to almost perfect for the subscores (0.53 ≤ k ≤ 0.96) for rater A. The inter-rater agreement was weaker on week 1, whereas the test-retest reliability was lower for the least experienced rater (rater B).ConclusionsThis study provides further evidence of the psychometric qualities of the Nociception Coma Scale. Future studies should assess the impact of practical experience and background on administration and scoring of the scale.© The Author(s) 2014.

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