Department of Medicine - DIMED, University of Padua, Padua, Italy.
Dement Geriatr Cogn Disord. 2012;34(1):38-43. doi: 10.1159/000341582. Epub 2012 Aug 15.
The aims of the present study were to report on the psychometric properties of the Pain Assessment in Advanced Dementia (PAINAD) scale by comparing it with the gold standard method of self-reporting on a numerical rating scale (NRS), and to provide a categorical version of the PAINAD scale comparable with the verbal descriptor scale of the NRS.
Six hundred elderly patients with various degrees of cognitive impairment consecutively admitted to the acute geriatric section at Padua University were evaluated. Cognitive, functional, and health statuses were evaluated using the Mini-Mental State Examination (MMSE), activities of daily living, and the Cumulative Illness Rating Scale (CIRS), respectively. Pain measurements were obtained by administering the NRS and the PAINAD scale.
Cognitive decline was recorded in 310 subjects (52%). The internal reliability of the PAINAD scale was adequate for all items, both in patients with dementia (α = 0.90) and in those with no cognitive impairment (α = 0.94). The psychometric evaluation demonstrated a stronger level of concurrent validity (Kendall's τ = 0.73, p < 0.0001) and inter-rater agreement (ĸ = 0.74, p < 0.0001) for the PAINAD compared with the NRS.
Our findings clearly indicate that the PAINAD scale is a reliable and easily administered tool for assessing pain intensity also in elderly patients with advanced dementia.
本研究旨在报告疼痛评估在晚期痴呆症（PAINAD）量表的心理测量特性，通过将其与数字评定量表（NRS）的金标准自我报告方法进行比较，并提供与 NRS 的言语描述量表可比的 PAINAD 量表的分类版本。
连续评估了 600 名患有不同程度认知障碍的老年患者。使用简易精神状态检查（MMSE）、日常生活活动和累积疾病评分量表（CIRS）分别评估认知、功能和健康状况。通过给予 NRS 和 PAINAD 量表来进行疼痛测量。
在 310 名患者（52%）中记录了认知能力下降。PAINAD 量表的内部可靠性对于痴呆症患者（α=0.90）和无认知障碍患者（α=0.94）的所有项目均足够。心理测量评估表明，PAINAD 与 NRS 相比，具有更强的同时有效性（Kendall's τ=0.73，p<0.0001）和评分者间一致性（ĸ=0.74，p<0.0001）。
我们的研究结果清楚地表明，PAINAD 量表是一种可靠且易于管理的工具，可用于评估患有晚期痴呆症的老年患者的疼痛强度。
