Brazilian version of the Pasero Opioid-Induced Sedation Scale: cross-cultural adaptation study

Leite, Sarah de Sá; Furlan, Maryana da Silva; Silva, Valquíria Aparecida da; Salvetti, Marina de Góes; Fonseca, Alessandra Santos da; Sanches, Mariana Bucci

doi:10.1590/1983-1447.2023.20230045.en

Sarah de Sá Leite

project administration

conceptualization

data curation

writing – original draft

writing – review & editing

investigation

methodology

validation

Hospital Nove de Julho. Centro de Oncologia. São Paulo, São Paulo, Brazil.

https://orcid.org/0000-0002-1415-6386

Maryana da Silva Furlan

formal analysis

conceptualization

data curation

supervision

methodology

validation

Prefeitura Municipal de Maringá. Maringá, Paraná, Brazil.

https://orcid.org/0000-0003-1273-6990

Valquíria Aparecida da Silva

writing – original draft

writing – review & editing

Universidade de São Paulo (USP). Faculdade de Medicina do Hospital das Clínicas. Departamento de Neurologia. São Paulo, São Paulo, Brazil.

Universidade de São Paulo (USP). Faculdade de Medicina do Hospital das Clínicas. Departamento de Psiquiatria. São Paulo, São Paulo, Brazil.

https://orcid.org/0000-0002-4113-1766

Marina de Góes Salvetti

formal analysis

writing – review & editing

supervision

Universidade de São Paulo (USP). Escola de Enfermagem. Departamento de Enfermagem Médico-Cirúrgica. São Paulo, São Paulo, Brazil.

https://orcid.org/0000-0002-4274-8709

Alessandra Santos da Fonseca

writing – original draft

writing – review & editing

Universidade de São Paulo (USP). Faculdade de Medicina do Hospital das Clínicas. Departamento de Neurologia. São Paulo, São Paulo, Brazil.

https://orcid.org/0000-0003-3785-4176

Mariana Bucci Sanches

project administration

formal analysis

conceptualization

data curation

writing – original draft

writing – review & editing

investigation

supervision

methodology

validation

Universidade de São Paulo (USP). Escola de Enfermagem. Departamento de Enfermagem Médico-Cirúrgica. São Paulo, São Paulo, Brazil.

Hospital Sírio-Libanês. São Paulo, São Paulo, Brazil.

https://orcid.org/0000-0003-3474-7375

Corresponding author:
Mariana Bucci Sanches E-mail: maribsanches@hotmail.com

Associate editor:

Gabriella de Andrade Boska

Editor-in-chief:

João Lucas Campos de Oliveira

The authors declare that there is no conflict of interest.

Translated version 1 (T1)			Translated version 2 (T2)			Synthesis Translation 12 (T12)
OPIOID-INDUCED SEDATION SCALE			PASERO OPIOID-INDUCED SEDATION SCALE			PASERO OPIOID-INDUCED SEDATION SCALE
POSS score	Description	Nursing actions	POSS score	Description	Nursing actions	POSS score	Description	Nursing actions
S	Sleeping, easily aroused	Acceptable, no action required	S	Sleeping, easily aroused	Acceptable, no action required	S	Sleeping, easily aroused	Acceptable, no action required
1	Awake and alert	Acceptable, no action required	1	Awake and alert	Acceptable, no action required	1	Awake and alert	Acceptable, no action required
2	Occasionally drousy, easy to arouse	Acceptable, no action required	2	Sleeping, easily aroused	Acceptable, no action required	2	Occasionally drowsy, easy to arouse	Acceptable, no action required
3	Frequently drowsy, arousable, drifts off to sleep during conversation	Unacceptable; monitor respiratory status and sedation level closely until stable at less than 3; recommend decreasing opioid dose 25%-50%; notify the professional that prescribed the opioid, consider administering a nonsedating nonopioid.	3	Frequently drowsy, arousable, drifts off to sleep during conversation	Unacceptable; monitor respiratory status and sedation level closely until stable at less than 3; recommend decreasing opioid dose 25%-50%; notify the professional that prescribed the opioid or the anesthesiologist, consider administering nonsedating, opioid-sparing nonopioid.	3	Frequently drowsy, arousable, drifts off to sleep during conversation	Unacceptable; monitor respiratory status and sedation level closely until stable at less than 3; recommend decreasing opioid dose 25%-50%; notify the professional that prescribed the opioid or the anesthesiologist, consider administering nonsedating nonopioid.
4	Sonolento, com resposta mínima ou nenhuma resposta à estimulação verbal ou física	Unacceptable, stop opioid; consider administering naloxone; notify the professional that prescribed the opioid or the anesthesiologist; monitor respiratory status and sedation level closely until stable at less than 3 and respiratory status is satisfactory.	4	Somnolent, minimal or no response to verbal or physical stimulation	Unacceptable, stop opioid; consider administering naloxone; notify the professional that prescribed the opioid or the anesthesiologist; monitor respiratory status and sedation level closely until stable at less than 3 and respiratory status is satisfactory.	4	Somnolent, minimal or no response to verbal or physical stimulation	Unacceptable, stop opioid; consider administering naloxone; notify the professional that prescribed the opioid or the anesthesiologist; monitor respiratory status and sedation level closely until stable at less than 3 and respiratory status is satisfactory.

	Items	CVI
	Items	1st round	2nd round
Sentence 1	Pasero opioid-induced sedation scale	1.00	1.00
Sentence 2	POSS score	1.00	1.00
Sentence 3	S, 1, 2, 3, 4	0.86	1.00
Sentence 4	Description	1.00	1.00
Sentence 5	Sleeping, easily aroused	0.86	1.00
Sentence 6	Awake and alert	1.00	1.00
Sentence 7	Occasionally drowsy, easy to arouse	0.86	1.00
Sentence 8	Frequently drowsy, arousable, drifts off to sleep during conversation	0.86	1.00
Sentence 9	Sonolento, resposta mínima ou inexistente a estímulos verbais ou físicos	0.86	1.00
Sentence 10	Nursing actions	1.00	1.00
Sentence 11	Acceptable, no action required	1.00	1.00
Sentence 12	Unacceptable; monitor respiratory status and sedation level closely until stable at less than 3; recommend decreasing opioid dose 25%-50%; notify the professional that prescribed the opioid or the anesthesiologist, consider administering nonsedating nonopioid	0.79	0.96
Sentence 13	Unacceptable, stop opioid; consider administering naloxone; notify the professional that prescribed the opioid or the anesthesiologist; monitor respiratory status and sedation level closely until stable at less than 3 and respiratory status is satisfactory	0.71	0.96
TOTAL		0.93	0.99

VARIABLES	N	%	MEAN±SD
Sociodemográfica data
Sex
Male	5	15.0
Female	28	85.0
Age Group (years)			35.48± 6.03
20-30	7	21.0
31-40	21	64.0
41-50	5	15.0
Educational level
Graduation	2	6.00
Specialization	30	91.0
MS	1	3.0
Professional experience (years)			8.18 ± 5.87
1 to 5	13	39.4
6 to 10	10	30.3
> 10	10	30.3
Unit where the professional works
Surgical Clinic	22	66.7
General Critical Unit	6	18.2
Intensive care	5	15.1
Experience onthetopic
Trouble evaluating the pain of the patient
Yes	5	15.0
No	28	85.0
Needed to use opioids to manage the patient's pain
Yes	33	100.0
No	-	-
Consider themselves apt to properly evaluate patients using opioids for pain management
Yes	28	85.0
No	5	15.0
Knows the main opioids used for pain management
Yes	30	91.0
No	3	9.0
Knows the opioid administration routes
Yes	32	97.0
No	1	3.0
Knows the opioid administration regimen
Yes	25	76.0
No	8	24.0
Knows how to differentiate acute, persistent, and chronic pain
Yes	29	88.0
No	4	12.0
Knows the in-hospital pain team
Yes	32	97.0
No	1	3.0
Knows how to contact the in-hospital pain team
Yes	32	97.0
No	1	3.0

POSS score	Description	Nursing interventions
0	Sleep, easy to arouse	Expected behavior, no action required at this time*
1	Awake and alert	Expected behavior, no action required at this time*
2	Slightly drowsy, easily aroused	Expected behavior, no action required at this time
3	Frequently drowsy, arousable, drifts off to sleep during conversation	Unnacceptable; monitor respiratory status† and sedation level rigorously until stable at less than 3; recommend decreasing opioid dose 25%-50%; notify the anesthesiologist or the professional that prescribed the opioid; consider administering a nonsedating nonopioid medication.
4	Somnolent, minimal or no response to verbal or physical stimulation	Unacceptable, stop opioid; consider administering naloxone; notify the anesthesiologist or the professional that prescribed the opioid; monitor respiratory status† and sedation level rigorously until stable at less than 3 and respiratory status is satisfactory

[1] Corresponding author:
Mariana Bucci Sanches E-mail: maribsanches@hotmail.com

Brasil

Brasil

Brazilian version of the Pasero Opioid-Induced Sedation Scale: cross-cultural adaptation study

Versión brasileña de la escala Pasero Opioid-Induced Sedation Scale: estudio de adaptación transcultural

ABSTRACT

Objective:

Method:

Results:

Conclusion: