Oosterman Joukje M, Zwakhalen Sandra, Sampson Elizabeth L, Kunz Miriam
Radboud University Nijmegen, Donders Institute for Brain, Cognition & Behaviour, Nijmegen, The Netherlands.
Maastricht University, Department of Health Services Research, CAPHRI School for Public Health & Primary Care, Maastricht, The Netherlands.
Neurodegener Dis Manag. 2016 Apr;6(2):119-31. doi: 10.2217/nmt-2015-0006. Epub 2016 Apr 1.
Facial expressions convey reliable nonverbal signals about pain and thus are very useful for assessing pain in patients with limited communicative ability, such as patients with dementia. In this review, we present an overview of the available pain observation tools and how they make use of facial expressions. Utility and reliability of facial expressions to measure pain in dementia are discussed, together with the effect of dementia severity on these facial expressions. Next, we present how behavioral alterations may overlap with facial expressions of pain, and may even influence the extent to which pain is facially expressed. The main focus is on disinhibition, apathy and emotional changes. Finally, an overview of theoretical considerations and practical implications is presented for assessing pain using facial expressions in clinical settings.
面部表情传达了关于疼痛的可靠非语言信号，因此对于评估沟通能力有限的患者（如痴呆症患者）的疼痛非常有用。在本综述中，我们概述了现有的疼痛观察工具以及它们如何利用面部表情。我们讨论了面部表情在测量痴呆症患者疼痛方面的实用性和可靠性，以及痴呆症严重程度对这些面部表情的影响。接下来，我们阐述行为改变如何与疼痛的面部表情重叠，甚至可能影响疼痛在面部表达的程度。主要关注的是去抑制、冷漠和情绪变化。最后，我们概述了在临床环境中使用面部表情评估疼痛的理论考量和实际意义。
