The Pain Assessment in Impaired Cognition scale (PAIC15): a multidisciplinary and international approach to develop and test a meta-tool for pain assessment in impaired cognition, especially dementia.

The Pain Assessment in Impaired Cognition scale (PAIC15): a multidisciplinary and international approach to develop and test a meta-tool for pain assessment in impaired cognition, especially dementia.

Publication date: Sep 05, 2019

Over the last decades, a considerable number of observational scales have been developed to assess pain in persons with dementia. The time seems ripe now to build on the knowledge and expertise implemented in these scales to form an improved, “best-of” meta-tool. The EU-COST initiative “Pain in impaired cognition, especially dementia” aimed to do this by selecting items out of existing observational scales and critically re-assessing their suitability to detect pain in dementia. This paper reports on the final phase of this collaborative task.

Items from existing observational pain scales were tested for “frequency of occurrence (item difficulty)”, “reliability”, and “validity”. This psychometric testing was carried out in eight countries, in different healthcare settings, and included clinical as well as experimental pain conditions.

Across all studies, 587 persons with dementia, 27 individuals with intellectual disability, 12 Huntington’s disease patients, and 59 cognitively healthy controls were observed during rest and movement situations or while receiving experimental pressure pain, respectively. The psychometric outcomes for each item across the different studies were evaluated within an international and multidisciplinary team of experts and led a final selection of 15 items (5x facial expressions, 5x body movements, 5x vocalizations).

The final list of 15 observational items have demonstrated psychometric quality and clinical usefulness both in their former scales and in the present international evaluation; accordingly, they qualified twice to form a new internationally agreed-on meta-tool for Pain Assessment in Impaired Cognition, the PAIC-15 scale. This article is protected by copyright. All rights reserved.

Kunz, M., de Waal, M.W., Achterberg, W.P., Gimenez-Llort, L., Lobbezoo, F., Sampson, E.L., van Dalen-Kok, A.H., Defrin, R., Invitto, S., Konstantinovic, L., Oosterman, J., Petrini, L., van der Steen, J.T., Strand, L.I., de Tommaso, M., Zwakhalen, S., Husebo, B.S., and Lautenbacher, S. The Pain Assessment in Impaired Cognition scale (PAIC15): a multidisciplinary and international approach to develop and test a meta-tool for pain assessment in impaired cognition, especially dementia. 06668. 2019 Eur J Pain.

Concepts Keywords
COST Meta tool
Dementia Countries healthcare settings
EU Test meta tool
Frequency Studies persons dementia
Healthcare Pain dementia
Huntington Pain persons dementia
Impaired Cognition Perception
Intellectual Disability Medicine
Pain Cognitive disorders
Psychometric Psychiatric diagnosis
Psychometric Testing Clinical medicine
Pain
Pain scale
Nociception
Dementia
Delirium

Semantics

Type Source Name
disease MESH facial expressions
gene UNIPROT REST
disease DOID intellectual disability
disease MESH intellectual disability
gene UNIPROT KCNK3
disease DOID dementia
disease MESH dementia

Original Article

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