Cultural adaptation and reproducibility validation of the Brazilian Portuguese version of the Pain Assessment in Advanced Dementia (PAINAD-Brazil) scale in non-verbal adult patients

Abstract

Objective To adapt the Pain Assessment in Advanced Dementia (PAINAD) scale to Brazilian Portuguese with respect to semantic equivalence and cultural aspects, and to evaluate the respective psychometric properties (validity, feasibility, clinical utility and inter-rater agreement).Methods Two-stage descriptive, cross-sectional retrospective study involving cultural and semantic validation of the Brazilian Portuguese version of the scale, and investigation of its psychometric properties (validity, reliability and clinical utility). The sample consisted of 63 inpatients presenting with neurological deficits and unable to self-report pain.Results Semantic and cultural validation of the PAINAD scale was easily achieved. The scale indicators most commonly used by nurses to assess pain were “Facial expression”, “Body language” and “Consolability”. The Brazilian Portuguese version of the scale has proved to be valid and accurate; good levels of inter-rater agreement assured reproducibility.Conclusion The scale has proved to be useful in daily routine care of hospitalized adult and elderly patients in a variety of clinical settings. Short application time, ease of use, clear instructions and the simplicity of training required for application were emphasized. However, interpretation of facial expression and consolability should be given special attention during pain assessment training.

Spanish adaptation and validation of the Pain Assessment Scale in Advanced Dementia (PAINAD) in patients with dementia and impaired verbal communication: cross-sectional study

“…The found reliability was similar to the values obtained in the validation of other languages, such as the Italian version of this tool, with an internal consistency of 0.74 31 ; the Brazilian version, whose value of the Cronbach's alpha was 0.65 35 or the German version, which has the best results, since internal consistency reached 0.85. 37 However, the results of the Spanish version of the PAINAD scale are even better if we remove the breathing dimension (Cronbach's alpha of 0.81 and 0.85).…”

“…24 However, previous studies point to the PACSLAC scale as the tool of choice for research studies, and the PAINAD scale as the ideal tool for assessing pain in clinical practice. [25][26][27][28] Therefore, the PAINAD scale has been culturally adapted and validated for the assessment of pain in people with advanced dementia in different countries, such as Singapore, 29 the Netherlands, 30 Italy, 31 China, 32 the UK, 33 the USA, 34 Brazil, 35 Turkey 36 and Germany. 37 However, its previous validation in Spanish has been superficial due to limitations of sample size and sample origin, 38 39 and further validation studies with larger samples are therefore required.…”

Instruments for pain assessment in patients with advanced dementia: A systematic review of the evidence for Latin America

“…Among the characteristics of the studies included in the systematic review, the scale most utilized was PAINAD, which was included in five studies in its Spanish (Spain) and Portuguese (Brazil) versions (Batalha et al, 2012; De La Rica Escuín and González Vaca, 2014; Gallego Valera et al, 2014; García-Soler et al, 2014; Pinto et al, 2015). The Abbey scale was only used in Spain (Chamorro and Puche, 2013), while the PACSLAC and McGill scales were used only in Brazil (De Souza Rolim et al, 2014a, 2014b; Bezerra Thé et al, 2016).…”

Pragmatic evaluation of an observational pain assessment scale in the emergency department: The Pain Assessment in Advanced Dementia (PAINAD) scale

“…In North America the Pain Assessment in Advanced Dementia (PAINAD) is recommended for acute pain assessment for people who are unable to selfreport 24 . However, while PAINAD has been tested in acute and dementia in-patient wards in many countries 22,[25][26][27][28] it has not been specifically tested in ED. One pilot study did demonstrate an improvement in time to the administration of analgesia when the PAINAD scale was used for people with dementia who presented with a long bone fracture 29 .…”