An Interdisciplinary Expert Consensus Statement on Assessment of Pain in Older Persons

Hadjistavropoulos, Thomas; Herr, Keela; Turk, Dennis C.; Fine, Perry G.; Dworkin, Robert H.; Helme, Robert D.; Jackson, Kenneth C.; Parmelee, Patricia A.; Rudy, Thomas E.; Beattie, B. Lynn; Chibnall, John T.; Craig, Kenneth D.; Ferrell, Betty; Ferrell, Bruce A.; Fillingim, Roger B.; Gagliese, Lucia; Gallagher, Romayne; Gibson, Stephen; Harrison, Elizabeth; Katz, Benny; Keefe, Francis J.; Lieber, S.J.; Lussier, David; Schmader, Kenneth E.; Tait, Raymond C.; Weiner, Debra K.; Williams, John A.

doi:10.1097/ajp.0b013e31802be869

Cited by 492 publications

(409 citation statements)

References 342 publications

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“…In addition, its properties were not age-related. Moreover, according to a study of literature review, the NRS was easily to understand and recommended for pain assessment in elderly including those with none to mild or moderate CI (Hadjistavropoulos et al, 2007). Ware, Epps, Herr, and Packard (2006) supported the convergent validity of the NRS and its test-retest reliability at a 2-week interval in older minority adults including elderly with CI.…”

Section: Unidimensional Assessment Tools Based On Self-reportmentioning

confidence: 85%

“…The VDS was the most easily understandable and preferred scale and was suitable for all but patients with most severe CI; convergent validity of the VDS was high except in patients with severe CI (Closs et al, 2004). Moreover, according to a study of literature review, the VDS has been shown to be the most preferred and understandable tool and is recommended for pain assessment in illiterate patients and the patients with none to mild or moderate CI (Hadjistavropoulos et al, 2007). However, construct validity of the VDS was a little less strong in younger and older adults (Peters et al).…”

Section: Unidimensional Assessment Tools Based On Self-reportmentioning

confidence: 97%

“…Thus, convergent validity was assessed by calculating Pearson product-moment correlation coefficient between the VDS and each of the four pain scales. Since the NRS is another tool that is easily to understand and is recommended for pain assessment in elderly patients including those with none to mild or moderate CI from a study of literature review (Hadjistavropoulos et al, 2007), therefore, if the correlation between the NRS and the VDS is high enough, it would provide evidence for convergent validity of both the NRS and the VDS. For other three scales, the higher is the correlation, the higher the convergent validity of that scale.…”

Section: Factor Analysismentioning

confidence: 99%

“…Since the NRS is another tool that is easily to understand and is recommended for pain assessment in elderly with cognitive function ranging from none to mild or moderate CI from a study of literature review (Hadjistavropoulos et al, 2007), therefore, if the correlation between the NRS and the VDS is high enough (> .70), it will provide evidence for convergent validity of both the NRS and the VDS. Therefore, the Pearson product-moment correlation coefficient .90 between the NRS and the VDS in all subjects supported the convergent validity of both of them.…”

Section: Convergent Validitymentioning

confidence: 99%

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Psychometric properties of pain intensity scales comparing among postoperative adult patients, elderly patients without and with mild cognitive impairment in China

Zhou

Petpichetchian

Kitrungrote

2011

International Journal of Nursing Studies

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In China, there is a lack of studies to generate pain intensity scales to the patients with CI and compare the pain scales in various age groups. Therefore, this study would compare the psychometric properties of the evidence-supported pain intensity scales consisting of the Verbal Descriptor Scale (VDS), the Numeric Rating Scale (NRS), the Faces Pain Scale (FPS), the Numeric Box-21 Scale (BS-21), and the Colored Analogue Scale (CAS) in Chinese postoperative adults varying in ages including the elderly with mild CI. This was a descriptive comparative study and 200 surgical patients were recruited purposively from a university-affiliated hospital with 50 for each group: young adults (age 20 -44 years), middle-aged adults (age 45 -59 years), elderly (age ≥ 60 years) without CI, and elderly (age ≥ 60 years) with mild CI.Participants rated the vividly remembered, current, worst, least, and average pain, and indicated scale preference and simplicity. Scale face validity, concurrent validity, convergent validity, and test-retest reliability at a 3-day interval were assessed. Fisher's exact tests were used to investigate whether face validity was related to different age iv groups and the levels of CI. One-way ANOVA and Kruskal-Wallis test were used to test the differences of concurrent validity, convergent validity, and test-retest reliability of each pain scale among the four groups. Regarding face validity, the FPS was ranked best across the subjects as nearly half of the patients selected it as both the most preferred and simplest and it had low errors; the VDS and the NRS were similar and ranked following the FPS; however, the BS-21 and the CAS were ranked last. The concurrent validity, convergent validity, and test-retest reliability of all five pain scales were supported in use with the four groups. The differences in psychometric properties among the four groups were only found in face validity. The findings support the psychometric properties of all five pain scales for pain assessment in Chinese adults including the elderly with mild CI. However, the FPS appears to be the best scale followed by the VDS and the NRS. ACKNOWLEDGEMENTSIt is impossible to finish this work without the continuous help and love from the people around me. I take this opportunity to give thanks to them for their willing to teach, guidance, help, and care during my master degree study.

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Section: Unidimensional Assessment Tools Based On Self-reportmentioning

confidence: 85%

Section: Unidimensional Assessment Tools Based On Self-reportmentioning

confidence: 97%

Section: Factor Analysismentioning

confidence: 99%

Section: Convergent Validitymentioning

confidence: 99%

See 2 more Smart Citations

Psychometric properties of pain intensity scales comparing among postoperative adult patients, elderly patients without and with mild cognitive impairment in China

Zhou

Petpichetchian

Kitrungrote

2011

International Journal of Nursing Studies

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“…The physical examination should target the musculoskeletal and neurological systems which are the most frequent causes of chronic pain 33 and should comprise the following:…”

Section: Physical Examinationmentioning

confidence: 99%

Assessment of patients with chronic pain

Meyer

Kenny

2010

South African Family Practice

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Management of Persistent Pain in the Older Patient

Makris

Abrams

Gurland

et al. 2014

JAMA

263

201

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Importance Persistent pain is highly prevalent, costly, and frequently disabling in later life. Objective To describe barriers to the management of persistent pain among older adults, summarize current management approaches, including pharmacologic and nonpharmacologic modalities; present rehabilitative approaches; and highlight aspects of the patient-physician relationship that can help to improve treatment outcomes. This review is relevant for physicians who seek an age-appropriate approach to delivering pain care for the older adult. Evidence Acquisition Search of MEDLINE and the Cochrane database from January 1990 through May 2014, using the search terms older adults, senior, ages 65 and above, elderly, and aged along with non-cancer pain, chronic pain, persistent pain, pain management, intractable pain, and refractory pain to identify English-language peer-reviewed systematic reviews, meta-analyses, Cochrane reviews, consensus statements, and guidelines relevant to the management of persistent pain in older adults. Findings Of the 92 identified studies, 35 evaluated pharmacologic interventions, whereas 57 examined nonpharmacologic modalities; the majority (n = 50) focused on older adults with osteoarthritis. This evidence base supports a stepwise approach with acetaminophen as first-line therapy. If treatment goals are not met, a trial of a topical nonsteroidal anti-inflammatory drug, tramadol, or both is recommended. Oral nonsteroidal anti-inflammatory drugs are not recommended for long-term use. Careful surveillance to monitor for toxicity and efficacy is critical, given that advancing age increases risk for adverse effects. A multimodal approach is strongly recommended–emphasizing a combination of both pharmacologic and nonpharmacologic treatments to include physical and occupational rehabilitation, as well as cognitive-behavioral and movement-based interventions. An integrated pain management approach is ideally achieved by cultivating a strong therapeutic alliance between the older patient and the physician. Conclusions and Relevance Treatment planning for persistent pain in later life requires a clear understanding of the patient's treatment goals and expectations, comorbidities, and cognitive and functional status, as well as coordinating community resources and family support when available. A combination of pharmacologic, nonpharmacologic, and rehabilitative approaches in addition to a strong therapeutic alliance between the patient and physician is essential in setting, adjusting, and achieving realistic goals of therapy.

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An Interdisciplinary Expert Consensus Statement on Assessment of Pain in Older Persons

Cited by 492 publications

References 342 publications

Psychometric properties of pain intensity scales comparing among postoperative adult patients, elderly patients without and with mild cognitive impairment in China

Psychometric properties of pain intensity scales comparing among postoperative adult patients, elderly patients without and with mild cognitive impairment in China

Assessment of patients with chronic pain

Management of Persistent Pain in the Older Patient

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