Lotan Meir, Ljunggren Elisabeth A, Johnsen Tom B, Defrin Ruth, Pick Chaim G, Strand Liv I
Department of Public Health and Primary Health Care, Section for Physiotherapy Science, University of Bergen, Norway.
J Pain. 2009 Apr;10(4):398-407. doi: 10.1016/j.jpain.2008.09.006. Epub 2009 Feb 8.
Despite enhanced interest in manifestations of pain in adults with intellectual and developmental disabilities (IDD), the characteristics of pain behavior in this group have seldom been examined. The aim of the present study was to provide a sensitive pain behavior scale for adults with IDD. The participants, 228 adults (mean age, 38.7 years) with different levels of IDD, were videotaped before and during an influenza vaccination and scored using the Non-Communicating Children's Pain Checklist-Revised (NCCPC-R). Observed pain behaviors not captured by the NCCPC-R, was also registered. Sensitivity to pain of all 27 items was examined by Signed Rank test, internal consistency by Cronbach's alpha, and sensitivity to change of the total scale by Standardized Response Mean (SRM). Thirteen items were excluded from the original NCCPC-R scale; 4 new items were added, making a modified scale of 18 items. This scale, named the Non-Communicating Adults Pain Checklist-Revised (NCAPC), was rescored and examined for psychometric properties in a random sample (N = 89). Sensitivity to pain of all items (P < .05) and high internal consistency (alpha = 0.773) were demonstrated. Large sensitivity to pain at all levels of IDD was shown (SRM, 1.20 to 2.07). Better psychometric properties were demonstrated for NCAPC than NCCPC-R in the target population.
This article presents initial psychometric properties of a new measure, the NCAPC, evaluating pain behavior in adults with IDD. This measure could help clinicians to better capture pain expressions in this population and contribute to better pain management for this group of patients.
尽管人们对智力和发育障碍(IDD)成人的疼痛表现兴趣增强,但该群体疼痛行为的特征很少得到研究。本研究的目的是为IDD成人提供一种敏感的疼痛行为量表。228名不同程度IDD的成人(平均年龄38.7岁)在流感疫苗接种前和接种期间被录像,并使用修订后的非言语儿童疼痛检查表(NCCPC-R)进行评分。未被NCCPC-R捕捉到的观察到的疼痛行为也被记录下来。通过符号秩检验检查所有27个项目的疼痛敏感性,通过克朗巴赫α系数检查内部一致性,通过标准化反应均值(SRM)检查总量表的变化敏感性。从原始的NCCPC-R量表中排除了13个项目;增加了4个新项目,形成了一个18个项目的修订量表。这个量表名为修订后的非言语成人疼痛检查表(NCAPC),在一个随机样本(N = 89)中重新评分并检查其心理测量特性。所有项目的疼痛敏感性(P < .05)和高内部一致性(α = 0.773)得到了证明。在所有IDD水平上都显示出对疼痛的高敏感性(SRM,1.20至2.07)。在目标人群中,NCAPC的心理测量特性优于NCCPC-R。
本文介绍了一种新测量方法NCAPC的初步心理测量特性,该方法用于评估IDD成人的疼痛行为。这种测量方法可以帮助临床医生更好地捕捉该人群的疼痛表达,并有助于为这组患者进行更好的疼痛管理。