OBSERVATIONAL INSTRUMENTS IN THE PSYCHOMETRY OF PAIN IN NON-COMMUNICATIVE PATIENTS WITH DEMENTIA: AN INTEGRATIVE REVIEW
DOI:
https://doi.org/10.56238/arev7n11-288Keywords:
Psychometrics, Pain, Aged, Dementia, Palliative CareAbstract
Introduction: Pain is underdiagnosed and undertreated in the demented elderly. Therefore, in order to be able to relieve suffering in this population, it is necessary to look for ways to identify this symptom in those with difficulties to communicate it. Objective: To identify observational tools for pain assessment in patients with dementia, as well as their psychometric properties Method: Integrative literature review in which data collection was carried out between January and March 2021, through the search of publications in journals indexed in MEDLINE, IBECS, LILACS and BDENF databases. Result: The sample consisted of five validated tools, presented in chronological order of publication and with their respective psychometric properties identified and organized. Each instrument had its clinical utility studied and subjected to a qualitative evaluation. Conclusion: The findings of this research revealed five high-quality studies, in which behavioral observation tools were developed and validated for pain assessment in elderly people with dementia. Their psychometric properties have been identified and organized, leading to a better understanding of its possibilities and limitations. The gaps in knowledge thus identified simultaneously create an ethical imperative and research opportunities on this topic.
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1. Raja, Srinivasa N.; Carr, Daniel B.; Cohen, Milton; Finnerup, Nanna B.; Flor, Herta; Gibson, Stephen; Keefe, Francis J.; Mogil, Jeffrey S.; Ringkamp, Matthias; Sluka, Kathleen A.; Song, Xue-Jun; Stevens, Bonnie; Sullivan, Mark D.; Tutelman, Perri R.; Ushida, Takahiro; Vader, Kyle The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises, PAIN: September 2020 - Volume 161 - Issue 9 - p 1976-1982 doi: 10.1097/j.pain.0000000000001939 DOI: https://doi.org/10.1097/j.pain.0000000000001939
2. Desantana, Josimari Melo et al . Definição de dor revisada após quatro décadas. BrJP, São Paulo, v. 3, n. 3, p. 197-198, Set. 2020 https://doi.org/10.5935/2595-0118.20200191. DOI: https://doi.org/10.5935/2595-0118.20200191
3. Santos, Fania Cristina et al . Chronic pain in long-lived elderly: prevalence, characteristics, measurements and correlation with serum vitamin D level. Rev. dor, São Paulo , v. 16, n. 3, p. 171-175, Sept. 2015 DOI: https://doi.org/10.5935/1806-0013.20150034
4. Mosele M, Inelmen E, M, Toffanello E, D, Girardi A, Coin A, Sergi G, Manzato E: Psychometric Properties of the Pain Assessment in Advanced Dementia Scale Compared to Self Assessment of Pain in Elderly Patients. Dement Geriatr Cogn Disord 2012;34:38-43. doi: 10.1159/000341582 DOI: https://doi.org/10.1159/000341582
5. Alzheimer’s Disease International (ADI): World Alzheimer Report. http://www.alz.co.uk/research/files/WorldAlzheimerReport.pdf
6. Burlá, Claudia et al. Panorama prospectivo das demências no Brasil: um enfoque demográfico. Ciênc. saúde coletiva, Rio de Janeiro, v. 18, n. 10, p. 2949-2956, Oct. 2013 DOI: https://doi.org/10.1590/S1413-81232013001000019
7. Jensen-Dahm C, Vogel A, Waldorff FB, Waldemar G. Discrepancy between self- and proxy-rated pain in Alzheimer's disease: results from the Danish Alzheimer Intervention Study. J Am Geriatr Soc. 2012 Jul;60(7):1274-8. doi: 10.1111/j.1532-5415.2012.04036.x. Epub 2012 Jun 15. PMID: 22702408. DOI: https://doi.org/10.1111/j.1532-5415.2012.04036.x
8. Sampson EL, White N, Lord K, Leurent B, Vickerstaff V, Scott S, Jones L. Pain, agitation, and behavioural problems in people with dementia admitted to general hospital wards: a longitudinal cohort study. Pain. 2015 Apr;156(4):675-683. doi: 10.1097/j.pain.0000000000000095. PMID: 25790457; PMCID: PMC4381983. DOI: https://doi.org/10.1097/j.pain.0000000000000095
9. Jonas H. The burden and blessing of mortality. In: Kass L, editor. Being human: core readings in the humanities. Readings from the President’s Council of Bioethics. Washington: W.W. Norton; 2004. p. 413-25.
10. IAHPC Global Project – Consensus Based Palliative Care Definition Radbruch L, De Lima L, Knaul F, et al. Redefining Palliative Care – A New Consensus-Based Definition. J Pain Symptom Manage. 2020;60(4):754-764. doi:10.1016/j.jpainsymman.2020.04.027 DOI: https://doi.org/10.1016/j.jpainsymman.2020.04.027
11. World Health Organization. Strengthening of palliative care as a component of comprehensive care throughout the life course. Geneva: WHO, 2014. Disponível em http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_R19-en.pdf Acessado em 04/01/2022.
12. World Health Organization. National cancer control programmes: policies and managerial guidelines. 2.ed. Geneva: WHO, 2002.
13. Malara, Alba et al. ‘Pain Assessment in Elderly with Behavioral and Psychological Symptoms of Dementia’. 1 Jan. 2016 : 1217 – 1225. DOI: https://doi.org/10.3233/JAD-150808
14. Fernandez Rojas, Raul; Huang, Xu; Ou, Keng-Liang. - Toward a functional near-infrared spectroscopy-based monitoring of pain assessment for nonverbal patients. - J Biomed Opt;22(10): 1-12, 2017 Oct. DOI: https://doi.org/10.1117/1.JBO.22.10.106013
15. Atee M, Hoti K, Parsons R, Hughes JD. A novel pain assessment tool incorporating automated facial analysis: interrater reliability in advanced dementia. Clin Interv Aging. 2018;13:1245-1258 https://doi.org/10.2147/CIA.S168024 DOI: https://doi.org/10.2147/CIA.S168024
16. Cantón-Habas, Vanesa; Carrera-González, María Del Pilar; Moreno-Casbas, María Teresa; Quesada-Gómez, José Manuel; Rich-Ruiz, Manuel. - Correlation between biomarkers of pain in saliva and PAINAD scale in elderly people with cognitive impairment and inability to communicate: descriptive study protocol. - BMJ Open;9(11): e032927, 2019 11 10. DOI: https://doi.org/10.1136/bmjopen-2019-032927
17. Epker J. Psychometric methods for measuring pain. Clin Neuropsychol. 2013;27(1):30-48. doi: 10.1080/13854046.2012.739203. Epub 2012 Nov 26. PMID: 23181338. DOI: https://doi.org/10.1080/13854046.2012.739203
18. Souza, Ana Cláudia de; Alexandre, Neusa Maria Costa; Guirardello, Edinêis de Brito. Propriedades psicométricas na avaliação de instrumentos: avaliação da confiabilidade e da validade. Epidemiol. Serv. Saúde, Brasília , v. 26, n. 3, p. 649-659, Sept. 2017. DOI: https://doi.org/10.5123/S1679-49742017000300022
19. Mendes, Karina Dal Sasso; Silveira, Renata Cristina de Campos Pereira; Galvão, Cristina Maria. - Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem - Integrative literature review: a research method to incorporate evidence in health care and nursing - Revisión integradora: método de investigación para la incorporación de evidencias en la salud y la enfermería - Texto & contexto enferm;17(4): 758-764, out.-dez. 2008. Ilus DOI: https://doi.org/10.1590/S0104-07072008000400018
20. The Joanna Briggs Institute. Joanna Briggs Institute Reviewers’ Manual: 2014 edition. Adelaide: The Joanna Briggs Institute, 2014.
21. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097. doi:10.1371/journal.pmed1000097 DOI: https://doi.org/10.1371/journal.pmed.1000097
22. Cervo FA, Raggi RP, Bright-Long LE, et al. Use of the Certified Nursing Assistant Pain Assessment Tool (CPAT) in Nursing Home Residents With Dementia. Am J Alzheimers Dis Other Demen 2007;22: 112-119. DOI: https://doi.org/10.1177/1533317506298907
23. Tsai PF, Beck C, Richards KC, Phillips L, Roberson PK, Evans J. The Pain Behaviors for Osteoarthritis Instrument for Cognitively Impaired Elders (PBOICIE). Res Gerontol Nurs. 2008 Apr;1(2):116-22. doi: 10.3928/19404921-20080401-07. PMID: 20078024; PMCID: PMC2844125. DOI: https://doi.org/10.3928/19404921-20080401-07
24. Husebo BS, Strand LI, Moe-Nilssen R, Husebo SB, Ljunggren AE. Pain in older persons with severe dementia. Psychometric properties of the Mobilization-Observation-Behaviour-Intensity-Dementia (MOBID-2) Pain Scale in a clinical setting. Scand J Caring Sci 2010; 24: 380-91. DOI: https://doi.org/10.1111/j.1471-6712.2009.00710.x
25. Chan S, Hadjistavropoulos T, Williams J, Lints-Martindale A. Evidence-based development and initial validation of the pain assessment checklist for seniors with limited ability to communicate-II (PACSLAC-II). Clin J Pain 2014;30:816e824. DOI: https://doi.org/10.1097/AJP.0000000000000039
26. Corbett A, Achterberg W, Husebo B, et al. EU-COST action td1005 Collaborators. An international road map to improve pain assessment in people with impaired cognition: the development of the Pain Assessment in Impaired Cognition (PAIC) meta-tool. BMC Neurol 2014;14:229. Disponível em: https://paic15.com Acessado em 15/03/2021. DOI: https://doi.org/10.1186/s12883-014-0229-5
27. de Waal, MWM, van Dalen‐Kok, AH, de Vet, HCW, et al. Observational pain assessment in older persons with dementia in four countries: Observer agreement of items and factor structure of the Pain Assessment in Impaired Cognition. Eur J Pain. 2020; 24: 279– 296. https://doi.org/10.1002/ejp.1484 DOI: https://doi.org/10.1002/ejp.1484
28. Kappesser J, Voit S, Lautenbacher S, Hermann C (2020). Pain assessment for cognitively impaired older adults: do items of available observer tools reflect pain‐specific responses?. European Journal of Pain, https://doi.org/10.1002/ejp.1536 DOI: https://doi.org/10.1002/ejp.1536
29. van Dalen-Kok, Annelore H; Achterberg, Wilco P; Rijkmans, Wieke E; Tukker-van Vuuren, Sara A; Delwel, Suzanne; de Vet, Henrica Cw; Lobbezoo, Frank; de Waal, Margot Wm. - Pain Assessment in Impaired Cognition (PAIC): content validity of the Dutch version of a new and universal tool to measure pain in dementia. - Clin Interv Aging;13: 25-34, 2018. DOI: https://doi.org/10.2147/CIA.S144651
30. Bisquerra, R., Martínez, F., & Sarriera, J. C. (2004). Introdução à estatística: enfoque informático com o pacote estatístico SPSS. Porto Alegre: Artes Médicas.
31. Blytt KM, Flo-Groeneboom E, Erdal A, Bjorvatn B, Husebo BS. Sleep and its Association With Pain and Depression in Nursing Home Patients With Advanced Dementia - a Cross-Sectional Study. Front Psychol. 2021 Apr 20;12:633959. doi: 10.3389/fpsyg.2021.633959. PMID: 33959072; PMCID: PMC8093870. DOI: https://doi.org/10.3389/fpsyg.2021.633959
32. Twycross, R. Introducing Palliative Care. 4° Ed Radcliff Med Press,p.4-8, 2003
