Construction of the discomfort assessment scale for immobilized trauma victims (DASITV)

Background

Immobilization is an intervention widely administered to trauma victims and aims to reduce the victim’s movements, ensuring the alignment of anatomical structures suspected of being injured. Despite the benefits of immobilization, it is responsible for the occurrence of pressure injuries, increases in intercranial pressure, pain, and discomfort.

Aim

To develop an instrument to assess the discomfort caused by immobilization in trauma victims − Discomfort Assessment Scale for Immobilized Trauma Victims (DASITV).

Methods

A sequential mixed-methods design was used, divided into three distinct but complementary phases: (1) Conceptualization Phase − Construction of the DASITV; (2) Focus Group with a Panel of ten Technical Experts in the care of immobilized trauma victims to approve the DASITV proposal; (3) Acceptance of the scale proposal using a modified e-Delphi technique with 30 pre-hospital health professionals.

Results

The first phase led to the construction of a scale made up of two sub-scales. The Numerical Discomfort Scale assesses the level of discomfort the person reports from 0 to 10, with 0 being no discomfort and 10 being maximum discomfort. The second evaluation parameter gives the level of pressure in mmHg that the body exerts on the surface where it is immobilized. The combined interpretation of these two sub-scales leads to 4 different possibilities − ordered by level of severity. The Focus Group made it possible to improve the scale, with input from the group of experts and, using the modified e-Delphi technique, a wider group of professionals showed agreement with the DASITV.

Conclusion

This study allowed us to propose a preliminary scale to assess the discomfort felt by victims of trauma caused by immobilization.