Zwakhalen, Sandra M.G., van der Steen, Jenny T. and Najim, M.D. (2011) Which score most likely represents pain on the observational PAINAD pain scale for patients with dementia? Journal of the American Medical Directors Association, 13 (4). pp. 384-389. ISSN 1525-8610 (doi:https://doi.org/10.1016/j.jamda.2011.04.002)

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Abstract

Objectives: We sought to determine a cutoff score for the observational Pain Assessment in Advanced Dementia (PAINAD), to adequately assess pain in clinical nursing home practice and research.

Design and Setting: We used data from multiple sources. We performed a literature review on PAINAD, performed secondary data analysis of a study examining psychometric properties of PAINAD in nursing home patients with dementia, and performed another study in nursing home patients with dementia specifically aimed at determining a cutoff score for PAINAD.

Participants: Patients with dementia in long term care facilities.

Measurements: We related PAINAD scores (range 0 to 10) to (1) self-reported and proxy-reported pain by global clinical judgment and (2) scores on another pain assessment instrument (DOLOPLUS-2), and (3) we compared scores between painful and supposedly less painful conditions.

Results: Findings from this study showed that a cutoff value of 2 should serve as a trigger for a trial with pain treatment. Although the majority of patients scoring 1 or 0 were not in pain, pain could be ruled out.

Conclusion: Based on the findings of multiple available data sources, we recommend that a PAINAD score of 2 or more can be used as an indicator of probable pain. A score of 1 is a sign to be attentive to possible pain. Future work may focus on cutoff scores for the presence of pain and severe pain in other frequently used pain tools, and on further development of methodology to assess cutoff scores.

Copyright © 2012 - American Medical Directors Association, Inc.

Item Type:	Article
Additional Information:	[1] JAMDA is the official journal of AMDA: Dedicated to Long Term Care Medicine (formerly the American Medical Directors Association).
Uncontrolled Keywords:	nursing home, pain assessment, dementia, cutoff score, PAINAD (Pain Assessment in Advanced Dementia Scale)
Subjects:	R Medicine > R Medicine (General)
Pre-2014 Departments:	School of Health & Social Care > Department of Social Work & Health Development
Last Modified:	23 Sep 2019 12:39
URI:	http://gala.gre.ac.uk/id/eprint/10417

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