Feldt K S
School of Nursing, University of Minnesota, 6-101 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, USA.
Pain Manag Nurs. 2000 Mar;1(1):13-21. doi: 10.1053/jpmn.2000.5831.
This article critiques the literature on existing pain assessment instruments for cognitively impaired elders and reports findings of pilot testing of the Checklist of Nonverbal Pain Indicators. This instrument was designed to measure pain behaviors in cognitively impaired elders. Instrument testing was conducted on a population of elderly patients with hip fractures. Interrater reliability showed 93% agreement on the dichotomous checklist items. Behaviors occurred more frequently during movement in this population. Of the six pain-related behaviors in the instrument, facial grimaces/winces occurred in 44% of the patients tested. Observed pain behaviors were positively correlated with self-report of pain. No differences between observed pain behaviors in cognitively intact versus cognitively impaired older adults with hip fractures were noted. Limitations of the instrument and recommendations for tool use are discussed.
本文对有关认知障碍老年人现有疼痛评估工具的文献进行了批判，并报告了非语言疼痛指标清单的初步测试结果。该工具旨在测量认知障碍老年人的疼痛行为。对一组髋部骨折老年患者进行了工具测试。评分者间信度显示，在二分制清单项目上的一致性为93%。在这一人群中，行为在活动期间出现得更为频繁。在该工具的六种与疼痛相关的行为中，44%的受试患者出现了面部 grimaces / winces。观察到的疼痛行为与疼痛的自我报告呈正相关。未发现认知功能完好与认知障碍的髋部骨折老年人在观察到的疼痛行为上存在差异。文中讨论了该工具的局限性以及工具使用建议。
