Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Feb 17;24(1):66.
doi: 10.1186/s12883-024-03539-w.

Pain assessment tools in adults with communication disorders: systematic review and meta-analysis

Álvaro Sabater-Gárriz  1   2   3   4 , Jesús Molina-Mula  2   4 , Pedro Montoya  3   4 , Inmaculada Riquelme  5   6   7
Affiliations
Meta-Analysis

Pain assessment tools in adults with communication disorders: systematic review and meta-analysis

Álvaro Sabater-Gárriz et al. BMC Neurol. .

Abstract

Background: Verbal communication is the "gold standard" for assessing pain. Consequently, individuals with communication disorders are particularly vulnerable to incomplete pain management. This review aims at identifying the current pain assessment instruments for adult patients with communication disorders.

Methods: A systematic review with meta-analysis was conducted on PubMed, PEDRO, EBSCOhost, VHL and Cochrane databases from 2011 to 2023 using MeSH terms "pain assessment, "nonverbal communication" and "communication disorders" in conjunction with additional inclusion criteria: studies limited to humans, interventions involving adult patients, and empirical investigations.

Results: Fifty articles were included in the review. Seven studies report sufficient data to perform the meta-analysis. Observational scales are the most common instruments to evaluate pain in individuals with communication disorders followed by physiological measures and facial recognition systems. While most pain assessments rely on observational scales, current evidence does not strongly endorse one scale over others for clinical practice. However, specific observational scales appear to be particularly suitable for identifying pain during certain potentially painful procedures, such as suctioning and mobilization, in these populations. Additionally, specific observational scales appear to be well-suited for certain conditions, such as mechanically ventilated patients.

Conclusions: While observational scales dominate pain assessment, no universal tool exists for adults with communication disorders. Specific scales exhibit promise for distinct populations, yet the diverse landscape of tools hampers a one-size-fits-all solution. Crucially, further high-quality research, offering quantitative data like reliability findings, is needed to identify optimal tools for various contexts. Clinicians should be informed to select tools judiciously, recognizing the nuanced appropriateness of each in diverse clinical situations.

Trial registration: This systematic review is registered in PROSPERO (International prospective register of systematic reviews) with the ID: CRD42022323655 .

Keywords: Communication Disorders; Nonverbal Communication; Observational Scales; Pain; Pain Assessment; Physiological Monitoring.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart. Selection process
Fig. 2
Fig. 2
Risk of bias assessment: Overall risk of bias A Risk of bias summary B
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Fox MA, Ayyangar R, Parten R, Haapala HJ, Schilling SG, Kalpakjian CZ. Self-report of pain in young people and adults with spastic cerebral palsy: interrater reliability of the revised face, legs, activity, cry, and consolability (r-FLACC) scale ratings. Dev Med Child Neurol. 2019;61(1):69–74. doi: 10.1111/dmcn.13980. - DOI - PubMed
    1. von Baeyer CL, Spagrud LJ. Systematic review of observational (behavioral) measures of pain for children and adolescents aged 3 to 18 years. Pain. 2007;127(1–2):140–150. doi: 10.1016/j.pain.2006.08.014. - DOI - PubMed
    1. McKinnon C, White J, Morgan P, Harvey A, Clancy C, Fahey M, Antolovich G. Clinician perspectives of chronic pain management in children and adolescents with cerebral palsy and dyskinesia. Phys Occup Ther Pediatr. 2021;41(3):244–258. doi: 10.1080/01942638.2020.1847236. - DOI - PubMed
    1. New perspectives on the definition of pain Pain. 1996;67(1):3–6. doi: 10.1016/0304-3959(96)03135-1. - DOI - PubMed
    1. Ostojic K, Paget S, Kyriagis M, Morrow A. Acute and chronic pain in children and adolescents with cerebral palsy: prevalence, interference, and management. Arch Phys Med Rehabil. 2020;101(2):213–219. doi: 10.1016/j.apmr.2019.08.475. - DOI - PubMed