Nonverbal Pain Measurement for Elders: A Literature Review

Abstract

The aim of this study was to review studies on nonverbal pain measurement for elderly people. Methods: Through a literature search of the databases including RISS, Medline, and the Cumulative Index to Nursing and Allied Health Literature, a total of 41 studies published between January 2000 and June 2016 were identified. A comprehensive review was performed guided by a framework developed by the researchers. Results: Nine nonverbal pain measurement scales that were mentioned more than twice in the selected studies were identified. Facial expression, verbalization and vocalization, and body movements were categories presented in all of the scales. The Pain Assessment In Advanced Dementia Scale (PAINAD) was most frequently reported in studies and the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) showed the highest internal consistency (Cronbach's ⍺=.73~.92) while the Doloplus-2 showed the highest inter-rater reliability (r=.77~.97) and the PAINAD and the highest concurrent validity (r=.65~.95). Conclusion: The PAINAD, PACSLAC, and Doloplus-2 are useful scales for use with elders. However, it is difficult to conclude which scale is the most appropriate because of insufficient evidence. More methodological studies are necessary to examine reliability, validity and clinical utility of the measures identified above.

Reliability and Feasibility of the Pain Assessment in Advanced Dementia Scale–Korean Version (PAINAD-K)

“…Among these scales, only the PACSLAC has been validated in Korea ( Kim et al, 2014 ); it encompasses all six behavioral indices suggested by the GSA and can thus detect even small behavioral changes. However, as the PAC-SLAC is a lengthy instrument consisting of 60 items, which may be useful for monthly or quarterly assessments but is not appropriate for clinical practitioners in Korea that must assess patients' pain several times a day to provide immediate interventions ( Lee & Song, 2016 ). On the other hand, the PAINAD, developed by Warden et al in 2003, comprises the observation of five indices and is thus relatively easier to use.…”

The Association between Comorbidities and Comorbid Injuries on Treatment Outcome in Pediatric and Elderly Patients with Injuries in Korea: An Observational Study

“…Unlike pediatric injuries, even minor injuries in the elderly progress to severe conditions due to difficulties in recovery, resulting in a tremendous socioeconomic burden given the increased treatment cost [8], cost of support, and sequelae [9]. Injuries in older adults result in worsened visual acuity, hearing, and muscle strength, increasing the risk of falling and slipping.…”