Browse > Article

Validity, Reliability and Efficiency of Pain Self-report Scale in Elderly with Dementia  

Ryoo, Eon-Na (Red Cross College of Nursing)
Park, Kyung-Sook (Department of Nursing, Chung-Ang University)
Publication Information
Korean Journal of Adult Nursing / v.23, no.2, 2011 , pp. 111-122 More about this Journal
Abstract
Purpose: The aim on this study was to establish the validity, reliability and efficiency of a Pain Self-Report Scale for elderly with dementia and compare these results with an observational pain rating scale. Methods: Study subjects were 136 elderly with dementia who were residents in a nursing home, geriatric hospital, or day care center. The subject's pain was measured by five self-report scales and observational scale. DS-DAT (discomfort scale-dementia of the Alzheimer's type) was used for pain behavior observational measure. Cognitive state was assessed using the MMSE (Mini-Mental State Examination). Results: Observational rating correlated moderately with self-report (r=.225~.585, p<.05) and tended to underestimate pain intensity. Test-retest reliability was high for all five self-report scales, and the correlation between these scales was very strong (r=.735~.856, p<.05). Comprehension rate of VDS (verbal descriptor scale) was 88.3%, and NRS (numeric rating scale) 69.9%, FPS (face pain scale) 66.9%, HVAS (horizontal visual analog scale) and VVAS (vertical visual analog scale) 65.4%. Conclusion: Nurses should not apply observational scales routinely in demented patients as many of these are capable of reporting their own pain. Self-report, the highest standard of pain measurement can be reliably performed in a large proportion of demented elderly.
Keywords
Pain; Pain measurement; Dementia;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Ministry of Health and Welfare (2007). Strategies for dementia old adult. Retrieved June 10, from the Ministry for Health Welfare and Family Affairs Web site, http://www.mw.go.kr
2 Park, J. H., & Kwon, Y. C. (1989). Standardization of Korean version of the mini-mental state examination (MMSE-K) for use in the elderly. Part II, Diagnostic validity. Journal of the Korean Neuropsychiatric Association, 28 (3), 508- 513.
3 Pautex, S., Herrmann, F., Le Lous, P., Fabjan, M., Miche, J. P., Gold, G., et al. (2005). Feasibility and reliability of four pain self-assessment scales and correlation with an observational rating scale in hospitalized elderly demented patients. Journal of Gerontology, 61A (4), 524-529.
4 Pautex, S., Michon, A., Guedira, M., Emond, H., Le Lous, P., Samaras, D., et al. (2006). Pain in severe dementia: Selfassessment or observational scales? Journal of the American Geriatric Society, 54 (7), 1040-1045.
5 Scherder, E. J., & Bouma, A. (2000). Visual analogue scales for pain assessment in Alzheimer's disease. Gerontology, 46 (1), 47-53.
6 Melzack, R., & Katz, J. (1999). Pain measurements in person in pain, In P. D. Wall & R. Melzack (Eds.), Textbook of pain (4th ed.). Edinburgh, Churchill-Livingstone.
7 Agency for Health Care Policy and Research (1994). Management of cancer pain guideline overview. Journal of the National Medical Association, 86 (8), 571-634.
8 Kim, S. J., Ryoo, E. N., & Park, K. S. (2007). A study on pain, physical function, cognitive function, depression and agitation in elderly women with dementia. Journal of Korean Academy of Adult Nursing, 19 (3), 401-412.
9 Kwon, Y. C., & Park, J. H. (1989). Korean of mini-mental state examination (MMSE-K) Part I: Development of the test for the elderly. Journal of the Korean Neuropsychiatric Association, 28 (1), 125-135.
10 Lee, E. O., & Choi, M. A. (1993). Pain: Theory and Intervention. Seoul, Shinwang Publisher.
11 Kim, E. J. (2006). Nurses' attitudes and perceptions of pain in patients with severe dementia. Clinical Nursing Research, 12 (1), 159-167.
12 Horgas, A. L. (2005). Assessing pain in persons with dementia. Dermatology Nursing, 17 (6), 472-473.
13 Hurrley, K. A., & Mobily, P. R. (1992). Geriatric mental health: Chronic pain and depression. Journal of Psychosocial Nursing, 30 (9), 7-12.
14 Hurley, A. C., Volicer, B. J., Hanrahan, P. A., Houde, S., & Volicer, L. (1992). Assessment of discomfort in advanced Alzheimer's patients. Research in Nursing and Health, 15 , 369-377.
15 Kim, O. J. (2006). IRB and publication ethics, Regular workshop resources for the development of medical Journal in 2006. Korean Association of Medical Journal Editors.
16 Wynne, C. F., Ling, S. M., & Remsburg, R. (2000). Comparison of pain assessment instruments in cognitively intact and cognitively impaired nursing home residents. Geriatric Nursing, 21 (1), 20-23.
17 So, H. S., Suh, S. R., Kwon, I. G., Kim, Y. H., & Yoon, Y. H. (2005). Pain management made incredibly easy, Seoul, Koonsja Publisher.
18 Stolee, P., Hiller, L. M., Esbaugh, J., Bol, N., McKellar, L., & Gauthier, N. (2005). Instrument for the assessment of pain in older persons with cognitive impairment. Journal of American Geriatrics Society, 53 (2), 319-326.
19 Wong, D. L., Hockenberry-Eaton, M., Wilson, D., Winkelstein, M. L., & Schwartz, P. (2001). Wong's Essentials of Pediatric Nursing (6th ed.). St. Louis, Mosby.
20 Young, D. M. (2001). Pain in institutionalized elders with chronic dementia. Iowa University. Unpublished doctoral dissertation, Iowa.
21 Hadjistavropoulos, T., & Craig, K. D. (2002). A theoretical framework for understanding self-report and observational measures of pain: A communications model. Behaviour Research and Therapy, 40 , 551-570.
22 American Geriatrics Society [AGS] Panel on Persistent Pain in Older Persons (2002). The management of persistent pain in older persons. Journal of the American Society, 50 (Suppl 6), S205-S224.
23 Chang, S. O. (2007). Development and effect of pain management protocol for nursing home patients with dementia. Journal of Korean Academy of Fundamentals of Nursing, 14 (1), 29-43.
24 Closs, S. J., Barr, B., Briggs, M., Cash, K., & Seers, K. (2004). A comparison of five pain assessment scales for nursing home residents with varying degrees of cognitive impairment. Journal of Pain and Symptom Management, 27 (3), 196-205.
25 Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12 , 189-198.
26 Fordyce, W. E. (1976). Behavioral methods for chronic pain and illness. St. Louis, C.V. Mosby Co.