Validity and reliability of the checklist of non-verbal pain indicators in Albanian. First step

Background: in Albania there are no reliable tools to assess the presence of pain in non-verbal patients. The objective of our study was toprovide a linguistic validation of the Checklist Non-verbal Pain Indicators(CNPI) in Albanian.Methods: after the back-translation, we used the Albanian version in across-sectional study to verify both the reliability and the validity of thisinstrument in clinical settings. The Visual Analog Scale was adopted asgold standard. Cohen's kappa and the Pearson correlation coefficientwere also used. Construct validity of the CNPI was established by exploratory factor analysis (EFA), and internal consistency was measuredby Cronbach’s alpha.Results: an Albanian version with 7 items was obtained. The Pearsoncoefficient showed a strong correlation at rest (T0= .88) and during movement (T1= .87). A low level of agreement was found for Item 1 (VocalComplains – non-verbal) and Item 5 (Rubbing) (moderate agreement).For all the other items there was a high level of agreement, except forItem 7. The Pearson coefficient values indicate that there is a modestcorrelation between the two instruments in the measurement at T0(.5229), which however increases when scoring is registered at T1(.6214). The Cronbach’s alpha at T0 was .93 and at T1 was .87. EFAresulted with a 2-factor solution at T0 and a 3-factor solution at T1.Conclusions: the CNPI is a simple and short assessment tool with thepotential to facilitate alertness to make the staff aware of pain experience in non-verbal patients