Developing a Pain Intensity Measure for Persons with Dementia: Initial Construction and Testing.
Delphi Method
Dementia
Nursing Homes
Pain Assessment
Pain Measurement
Journal
Pain medicine (Malden, Mass.)
ISSN: 1526-4637
Titre abrégé: Pain Med
Pays: England
ID NLM: 100894201
Informations de publication
Date de publication:
01 06 2019
01 06 2019
Historique:
pubmed:
5
10
2018
medline:
29
4
2020
entrez:
5
10
2018
Statut:
ppublish
Résumé
The goal of this study was to identify a limited set of pain indicators that were most predicive of physical pain. We began with 140 items culled from existing pain observation tools and used a modified Delphi approach followed by statistical analyses to reduce the item pool. Through the Delphi Method, we created a candidate item set of behavioral indicators. Next, trained staff observed nursing home residents and rated the items on scales of behavior intensity and frequency. We evaluated associations among the items and expert clinicians' assessment of pain intensity. Four government-owned nursing homes and 12 community nursing homes in Alabama and Southeastern Pennsylvania. Ninety-five residents (mean age = 84.9 years) with moderate to severe cognitive impairment. Using the least absolute shrinkage and selection operator model, we identified seven items that best predicted clinicians' evaluations of pain intensity. These items were rigid/stiff body or body parts, bracing, complaining, expressive eyes, grimacing, frowning, and sighing. We also found that a model based on ratings of frequency of behaviors did not have better predictive ability than a model based on ratings of intensity of behaviors. We used two complementary approaches-expert opinion and statistical analysis-to reduce a large pool of behavioral indicators to a parsimonious set of items to predict pain intensity in persons with dementia. Future studies are needed to examine the psychometric properties of this scale, which is called the Pain Intensity Measure for Persons with Dementia.
Identifiants
pubmed: 30285252
pii: 5114535
doi: 10.1093/pm/pny180
pmc: PMC9513703
mid: NIHMS1832580
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
1078-1092Subventions
Organisme : HSRD VA
ID : I01 HX000507
Pays : United States
Organisme : RRD VA
ID : IK2 RX001824
Pays : United States
Informations de copyright
2018 American Academy of Pain Medicine. This work is written by US Government employees and is in the public domain in the US.
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