Abstract:Through an integrative literature review involving the CINAHL, Cochrane, Embase,
LILACS, PsycINFO, PubMed databases, tools available in the literature for
assessing pain in individuals with severe dementia were identified along with
versions validated for use in Brazil. We found 1501 relevant articles which,
after selection of abstracts and full reading, yielded a final sample of 33
articles. The analysis enabled the identification of 12 instruments: ABBEY PAIN
SCALE; ADD; CNPI; CPAT; DOLOPLUS-2; MOBID and MOB… Show more
“…As an alternative to verbal evaluation (or self-report), a significant number of observational scales have been developed in the last 15 years. Several literature review studies describe more than 24 tools of this type14–21 and although none of the tools can be recommended based on existing evidence, several studies advocate the inclusion of any of them within a comprehensive pain care protocol 1 10 22–25…”
IntroductionPain is an under-diagnosed problem in elderly people, especially in those with cognitive impairment who are unable to verbalise their pain. Although the Pain assessment in advanced dementia scale (PAINAD) scale is a tool recognised for its clinical interest in this type of patients, its correlation with the saliva biomarkers reinforced its utility. The aim of this research will be to correlate the scores of this scale with the levels of biomarkers of pain found in saliva samples of patients with cognitive impairment and inability to communicate.Methods and analysisThis is an observational study. The level of pain will be evaluated using the PAINAD scale. Moreover, pain biomarkers, in particular secretory IgA and soluble tumour necrosis factor receptor type II, will be determined in saliva. Both assessments will be conducted in 75 patients aged over 65 years with advanced cognitive impairment and inability to communicate. The PAINAD scores will be correlated with the levels of these biomarkers of pain. A control group consisting of 75 healthy subjects aged over 65 years will be included in the study. Moreover, sociodemographic variables and variables related to pain, dementia and other clinical conditions will be recorded. The analysis will be performed with the statistical package SPSS V.22 and the software R.Ethics and disseminationThe study has been reviewed and approved by the Andalusian Human Research Ethics Committee. In addition, this study has been financed by the Junta de Andalucía through a regional health research fund (Research code: PI-0357–2017). The results will be actively disseminated trough a high-impact journal in our study area, conference presentations and social media.
“…As an alternative to verbal evaluation (or self-report), a significant number of observational scales have been developed in the last 15 years. Several literature review studies describe more than 24 tools of this type14–21 and although none of the tools can be recommended based on existing evidence, several studies advocate the inclusion of any of them within a comprehensive pain care protocol 1 10 22–25…”
IntroductionPain is an under-diagnosed problem in elderly people, especially in those with cognitive impairment who are unable to verbalise their pain. Although the Pain assessment in advanced dementia scale (PAINAD) scale is a tool recognised for its clinical interest in this type of patients, its correlation with the saliva biomarkers reinforced its utility. The aim of this research will be to correlate the scores of this scale with the levels of biomarkers of pain found in saliva samples of patients with cognitive impairment and inability to communicate.Methods and analysisThis is an observational study. The level of pain will be evaluated using the PAINAD scale. Moreover, pain biomarkers, in particular secretory IgA and soluble tumour necrosis factor receptor type II, will be determined in saliva. Both assessments will be conducted in 75 patients aged over 65 years with advanced cognitive impairment and inability to communicate. The PAINAD scores will be correlated with the levels of these biomarkers of pain. A control group consisting of 75 healthy subjects aged over 65 years will be included in the study. Moreover, sociodemographic variables and variables related to pain, dementia and other clinical conditions will be recorded. The analysis will be performed with the statistical package SPSS V.22 and the software R.Ethics and disseminationThe study has been reviewed and approved by the Andalusian Human Research Ethics Committee. In addition, this study has been financed by the Junta de Andalucía through a regional health research fund (Research code: PI-0357–2017). The results will be actively disseminated trough a high-impact journal in our study area, conference presentations and social media.
ObjectivesThe aim of this study was to adapt and validate the Pain Assessment in Advanced Dementia (PAINAD) scale in Spanish.DesignCross-sectional observational study.SettingTwo health districts of Andalusian provinces, located in the south of Spain, through the Andalusian network of Primary Healthcare centres and four institutions dedicated to the care of patients with dementia.ParticipantsA total of 100 older people, with a medical diagnosis of dementia and a score on the Global Deterioration Scale between 5 and 7 were assessed using the PAINAD scale.Primary and secondary outcome measuresPsychometric properties including content validity, construct validity and reliability of the scale have been tested.ResultsThe overall Item Content Validity Index was excellent (0.95). Regarding construct validity, it was confirmed that a lower use of analgesics implied a lower score on the PAINAD scale (p<0.05). The internal consistency of the scale was 0.76 and it increases to 0.81 if we remove the breathing item. Furthermore, the intraclass correlation coefficient (ICC) used to assess interobserver reliability was 0.94, whereas the ICC used to assess temporary stability was 0.55.ConclusionsThe Spanish version of the PAINAD scale is a valid tool to assess pain in patients with dementia and inability to communicate verbally.
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