ABSTRACT
Objective To assess the pain of patients with disorders of consciousness(DOC) and e-valuate the reliability and validity of Chinese version of Nociception Coma Scale- revised ( NCS-R). Meth-ods Sixty-two patients with disorders of consciousness were assessed by NCS-R and the internal reliability, inter-rater reliability,test-retest reliability and concurrent validity was analyzed. Results Cronbach's alpha (α) of internal reliability was 0. 611, test-retest reliability for the NCS-R total scores by spearman was 0. 884. For the subscales,the reliability for the motor,verbal and facial subscale scores by Cronbach's kappa were 0. 856,0. 870 and 0. 856 respectively. Inter-rater reliability for the NCS-R total scores by spearman was 0. 662. For the subscales,the reliability for the motor,verbal and facial subscale scores by Cronbach's kappa were 0. 962,0. 867 and 0. 671 respectively. The spearman coefficient of concurrent validity was 0. 560 (all P<0. 01). Conclusion The NCS-R is a good valid scale and available for Chinese clinician and researchers to assess the pain of DOC patients.
ABSTRACT
Objective To evaluate the sensitivity of three different clinical consciousness scales to patients with disorders of consciousness.Methods A total of 84 patients in vegetative state (VS) were selected and scored by the consciousness scales including Glasgow Coma Scale (GCS),Coma Recovery Scale-Revised (CRS-R) and Chinese Vegetative State Scale (CVSS) respectively.The patients were followed every 2 weeks for 12 weeks or every 4 weeks for 12-24 weeks.The assessment finished in 6 months or till the time when patients emerged from minimally conscious state ( MCS.The diagnostic sensitivity and the sensitivities of each sub-scale in CRS-R were evaluated when the patients with MCS emerged from VS.The diagnostic consistency with other scales was observed and analyzed by Spearman correlation as well.The Spearman -relate was used to analyze the correlations among the total scores of three scales in the patients on admission (36 patients with acute and 48 patients with chronic phase).Results Of 84 VS patients,there were 47 emerged to MCS.CRS-R was the most sensitive in the diagnosis of MCS (P ＜ 0.05 ) among all scales.The visual subscale is the most sensitive among all the CRS-R subscales ( P ＜0.01 ).Among the 84 patients,the remaining 37 were diagnosed as VS by all three scales.The total scores correlation analysis showed that the score of CRS-R significantly correlate with that of GCS in acute and chronic phase ( P ＜0.01 ) and significantly correlate with that of CVSS only in the acute stage ( P ＜ 0.05 ).Conclusions It is indicated that CRS-R,especially the visual subscale of CRS-R is the more sensitive tool for detecting.MCS during recovery process in the disorders of consciousness.As to the patients with deep unconsciousness and with no significant recovery,the three instruments are in good agreement to determine the degree of disorders of consciousness.It is suggested that CRS-R can be widely used to assess the level of consciousness in various stages.