Kang Youjeong, Demiris George
School of Nursing, University of Washington, Seattle, WA, USA.
School of Nursing & School of Medicine, University of Washington, Seattle, WA, USA.
Int J Older People Nurs. 2018 Jun;13(2):e12170. doi: 10.1111/opn.12170. Epub 2017 Oct 5.
Pain is common in older adults, but it is often underreported or undertreated partly because many consider pain to be a normal consequence of ageing. Among the plethora of available self-report pain assessment tools, there is no synthetised evidence which tools are indicated for use among cognitively intact older adults.
To understand documented self-report pain assessment tools that have been used among cognitively intact older adults, and to describe their characteristics including overall performance as well as studies demonstrating their use.
A systematic search of the indexed databases PubMed, PsycINFO and Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus) was conducted to identify documented self-report pain assessment tools through peer-reviewed papers, including citations from January 1990 to December 2015. Thirty-five percentage of abstracts were independently evaluated by two raters according to specific criteria.
Among identified tools, the Iowa Pain Thermometer, the 6-point Verbal Descriptor Scale, the Numeric Rating Scale, the short form Brief Pain Inventory (BPI) and the Geriatric Pain Measure (GPM) may be suitable tools for self-reported pain by cognitively intact older adults based on the statement of the literature. Only two self-report tools (the GPM and the Geriatric Painful Events Inventory) were designed specifically for older adults.
More studies are needed to evaluate pain measures' psychometric performance across different settings, racial/ethnic groups and disease categories. Since 80% of older adults have at least one chronic disease, multidimensional tools such as the GPM may need to be used more often for accurate self-report of pain.
Examining the psychometric properties of comprehensive self-report pain assessment tools informs recommendations for the selection of tools to be used in clinical practice.
疼痛在老年人中很常见,但往往报告不足或治疗不足,部分原因是许多人认为疼痛是衰老的正常后果。在众多可用的自我报告疼痛评估工具中,没有综合证据表明哪些工具适用于认知功能正常的老年人。
了解已记录的在认知功能正常的老年人中使用的自我报告疼痛评估工具,并描述其特征,包括整体性能以及证明其使用的研究。
对索引数据库PubMed、PsycINFO和护理及相关健康文献累积索引(CINAHL Plus)进行系统检索,以通过同行评审论文识别已记录的自我报告疼痛评估工具,包括1990年1月至2015年12月的引文。35%的摘要由两名评估者根据特定标准独立评估。
根据文献陈述,在所识别的工具中,爱荷华疼痛温度计、6点言语描述量表、数字评定量表、简短形式简明疼痛问卷(BPI)和老年疼痛测量量表(GPM)可能是认知功能正常的老年人自我报告疼痛的合适工具。只有两种自我报告工具(GPM和老年疼痛事件量表)是专门为老年人设计的。
需要更多研究来评估疼痛测量工具在不同环境、种族/族裔群体和疾病类别中的心理测量性能。由于80%的老年人至少患有一种慢性病,可能需要更频繁地使用多维工具(如GPM)来准确自我报告疼痛。
检查综合自我报告疼痛评估工具的心理测量特性有助于为临床实践中工具的选择提供建议。