OBJECTIVE: The prevalence of chronic pain ranges from 40% to 80% in long-term care facilities, and it is especially high among older adults who are unable to communicate due to cognitive impairments. Although validated assessment tools exist, pain detection in this population is often done by interdisciplinary evaluation (IE), which largely relies on the subjective impression of health care providers. The aim of this study was to examine the agreement between the IE and validated observational pain tools. SETTING: We recruited 59 residents with limited ability to communicate. The pain behaviors of each participant were assessed with two validated tools, the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) and the Pain Assessment in Advanced Dementia (PAINAD), during transfer or mobilization. The results were then compared with the findings of the IE. RESULTS: The correlation between the PACSLAC and PAINAD was high (r = 0.79 [95% CI: 0.67-0.87]). However, we found a low to moderate association between the PACSLAC and the IE (r = 0.34 [95% CI: 0.09-0.55]), and a weaker association was observed between the PAINAD and the IE (r = 0.25 [95% CI: -0.02-0.48]). When the IE concluded that there was an absence of pain behavior, the PAINAD and the PACSLAC detected the presence of pain in 13.6% and 27.1% of the cases respectively. CONCLUSION: These results may be explained by an inability of IE to assess pain correctly or by instruments providing false positive results. Nevertheless, as detection of pain is difficult in this population, our research supports the use of validated tools to complement assessment of pain by the IE and make sure that no pain goes undetected. Wiley Periodicals, Inc.
OBJECTIVE: The prevalence of chronic pain ranges from 40% to 80% in long-term care facilities, and it is especially high among older adults who are unable to communicate due to cognitive impairments. Although validated assessment tools exist, pain detection in this population is often done by interdisciplinary evaluation (IE), which largely relies on the subjective impression of health care providers. The aim of this study was to examine the agreement between the IE and validated observational pain tools. SETTING: We recruited 59 residents with limited ability to communicate. The pain behaviors of each participant were assessed with two validated tools, the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) and the Pain Assessment in Advanced Dementia (PAINAD), during transfer or mobilization. The results were then compared with the findings of the IE. RESULTS: The correlation between the PACSLAC and PAINAD was high (r = 0.79 [95% CI: 0.67-0.87]). However, we found a low to moderate association between the PACSLAC and the IE (r = 0.34 [95% CI: 0.09-0.55]), and a weaker association was observed between the PAINAD and the IE (r = 0.25 [95% CI: -0.02-0.48]). When the IE concluded that there was an absence of pain behavior, the PAINAD and the PACSLAC detected the presence of pain in 13.6% and 27.1% of the cases respectively. CONCLUSION: These results may be explained by an inability of IE to assess pain correctly or by instruments providing false positive results. Nevertheless, as detection of pain is difficult in this population, our research supports the use of validated tools to complement assessment of pain by the IE and make sure that no pain goes undetected. Wiley Periodicals, Inc.
Entities:
Keywords:
Aging; Dementia; Long-Term Care Facilities; PACSLAC; PAINAD; Pain Assessment
Authors: Alba Malara; Giuseppe Andrea De Biase; Francesco Bettarini; Francesco Ceravolo; Serena Di Cello; Michele Garo; Francesco Praino; Vincenzo Settembrini; Giovanni Sgrò; Fausto Spadea; Vincenzo Rispoli Journal: J Alzheimers Dis Date: 2016 Impact factor: 4.472
Authors: Vanesa Cantón-Habas; María Del Pilar Carrera-González; María Teresa Moreno-Casbas; José Manuel Quesada-Gómez; Manuel Rich-Ruiz Journal: BMJ Open Date: 2019-11-10 Impact factor: 2.692