Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
Department of Anesthesiology, Erasmus MC, Rotterdam, The Netherlands.
J Intellect Disabil Res. 2021 Jul;65(7):675-687. doi: 10.1111/jir.12843. Epub 2021 May 5.
The Rotterdam Elderly Pain Observation Scale (REPOS) has not yet been validated for institutionalised cognitively impaired adults. To fill this gap of knowledge, we tested psychometric properties of the REPOS when used for pain assessment in this population.
In this multicentre observational study, residents were filmed during a possibly painful moment and at rest. Healthcare professionals were asked to rate residents' pain by means of a Numeric Rating Scale (NRS)-proxy. Two researchers assessed pain with the REPOS and the Chronic Pain Scale for Non Verbal Adults with Intellectual Disabilities (CPS-NAID) from video-recordings.
In total, 168 observations from 84 residents were assessed. Inter-observer reliability between the two researchers was good, with Cohen's kappa 0.72 [95% confidence interval (CI) 0.64 to 0.79]. Correlation between the REPOS and CPS-NAID for a possibly painful moment was 0.73 (95% CI 0.65 to 0.79). Sensitivity (85%) and specificity (61%) for the detection of pain were calculated with REPOS ≥ 3 and NRS ≥ 4 as a reference value. Item response theory analysis shows that the item grimace displayed perfect discrimination between residents with and without pain.
The REPOS is a reliable and valid instrument to assess pain in cognitively impaired individuals.
罗特丹老年疼痛观察量表（REPOS）尚未经过验证，不适用于机构内认知障碍的成年人。为了填补这一知识空白，我们在该人群中测试了 REPOS 用于疼痛评估的心理测量特性。
在这项多中心观察性研究中，居民在可能疼痛的时刻和休息时被拍摄下来。医护人员被要求通过数字评分量表（NRS）-代理来评估居民的疼痛。两名研究人员通过视频记录使用 REPOS 和非言语智力障碍成年人慢性疼痛量表（CPS-NAID）来评估疼痛。
总共评估了 84 名居民的 168 次观察。两名研究人员之间的观察者间可靠性良好，Cohen's kappa 为 0.72 [95%置信区间（CI）0.64 至 0.79]。REPOS 与 CPS-NAID 在可能疼痛时刻的相关性为 0.73（95%CI 0.65 至 0.79）。使用 REPOS ≥ 3 和 NRS ≥ 4 作为参考值，检测疼痛的敏感性（85%）和特异性（61%）。项目反应理论分析表明，表情痛苦项目在有疼痛和无疼痛的居民之间具有完美的区分能力。
REPOS 是评估认知障碍个体疼痛的可靠和有效的工具。
