Abstract
Background
A number of observational tools is available to assess pain in cognitively impaired older adults, however, none of them can yet be regarded as a ‘gold standard’. An international research initiative has created a meta‐tool compiling the facial, vocalization and body movement items of the majority of available tools. Objective of the present study was to investigate the pain specificity and the validity of these items.
Method
N = 34 older adults with or without cognitive impairment were videotaped in three different conditions (one reference, two painful conditions) in their nursing homes. They were further asked to self‐report their pain in each condition. The occurrence of non‐verbal behaviors was coded as present or absent using the items of the meta‐tool.
Results
The majority of non‐verbal behaviors was not pain sensitive as they occurred less than three times across participants and conditions. Of the remaining items, two facial items (‘pained expression’ and ‘raising upper lip’), one vocalization item (‘using pain related words’) and one body movement item (‘guarding’) were found to be pain specific and valid. One additional item, the vocalization item ‘gasping’, was pain‐specific, but not associated with pain self‐report, and three additional items, the facial items ‘frowning’ and ‘narrowing eyes’ and the vocalization item ‘mumbling’ were correlated with pain self‐report but did not help to separate pain from non‐pain conditions.
Conclusions
Systematic evaluation of items of existing observational pain assessment tools under naturalistic conditions seems a promising approach in the process of further investigating and improving tools.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/2NWnOo7
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