[The systematic evaluation of instruments designed to assess pain in persons with limited ability to communicate]
- PMID: 17717611
- PMCID: PMC2670710
- DOI: 10.1155/2007/705616
[The systematic evaluation of instruments designed to assess pain in persons with limited ability to communicate]
Abstract
Chronic pain is often underdetected and undertreated in long-term care facilities. The use of self-report measures of pain (such as the visual analogue scale) is often problematic for older adults residing in long-term care because of the high prevalence of visual and auditory deficits and severe cognitive impairment. Observational measures of pain have been developed to address this concern. A systematic grid designed to assess the properties of existing observational measures of pain was used for seniors with dementia. The grid focused on the evaluation of content validity (12 items), construct validity (12 items), reliability (13 items) and clinical utility (10 items). Among the 24 instruments that were evaluated, several were deemed to be promising in the assessment of pain among older persons with severe dementia. Nonetheless, additional research is needed before their routine integration in the practices of long-term care settings.
La douleur chronique est souvent sous-détectée et insuffisamment traitée dans les milieux de soins de longue durée. Les outils d’autorapport (ou autoévaluation) de la douleur, comme l’échelle visuelle analogique, n’ont été validés que partiellement chez les populations âgées, en raison de la prévalence élevée de déficits visuels, auditifs, moteurs et cognitifs que l’on y trouve. Des outils d’observation des patients ont été développés pour pallier ces difficultés d’utilisation des échelles d’autorapport de la douleur. Le présent projet vise l’identification de ces échelles et leur évaluation sur la base de la validité de contenu (12 questions), de la validité de construit (12 questions), de la fiabilité (13 questions) et de l’utilité clinique (10 questions). Parmi les 24 instruments recensés, plusieurs apparaissent prometteurs pour évaluer la douleur chez les personnes âgées atteintes de démence sévère. Des efforts additionnels de validation sont cependant requis avant leur intégration à la pratique régulière en soins de longue durée.
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