Sampson Elizabeth L, Davies Nathan, Vickerstaff Victoria
Queen Mary University of London-Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, London, UK.
Whipps Cross Hospital, Barts Health NHS Trust-Academic Centre for Healthy Ageing (ACHA), London, UK.
Age Ageing. 2025 Feb 2;54(2). doi: 10.1093/ageing/afaf027.
Pain is common in people with dementia in general hospitals. This can be difficult to identify.
To evaluate the psychometric properties of PainChek electronic pain assessment tool.
Cross-sectional psychometric study.
Six medical care of older people wards from two general hospitals in greater London, UK.
63 people with clinical diagnosis of dementia: mean 84 years (SD 6.7), 59% female, 69% living in their own homes, 64% white British, 77% moderate/severe dementia.
Psychometric evaluation of PainChek, a point-of-care electronic pain assessment tool combining artificial intelligence, facial analysis and smartphone technology. From a total of 216 assessments, we tested PainChek's inter-rater reliability (IRR) (Cohen's kappa), internal consistency (Cronbach's alpha) and concurrent validity (Pearson's coefficient) between PainChek and Pain Assessment in Advanced Dementia (PAINAD) scores at rest and post-movement [95% confidence interval (95% CI) where appropriate]. We assessed convergent validity with Symptom Management-End of Life in Dementia scale (SM-EOLD) (Pearson's coefficient) and discriminant validity (rest vs post-movement).
IRR was 0.714 (95% CI 0.562 to 0.81) (rest) and 0.817 (95% CI 0.692 to 0.894) (post-movement). Internal consistency was 0.755 (rest) and 0.833 (post-movement). Concurrent validity with PAINAD was 0.528 (95% CI 0.317 to 0.690) (rest) and 0.787 (0.604 to 0.891) (post-movement). Convergent validity with SM-EOLD was -0.555 (95% CI -0.726 to -0.318) (rest) and -0.5644 (95% CI -0.733 to -0.331) (post-movement). Discriminant validity was significant.
PainChek is a valid and reliable pain assessment tool for people with dementia in general hospitals. Further consideration will be needed for implementation into this setting.
在综合医院中，痴呆症患者普遍存在疼痛问题。而这可能难以识别。
评估PainChek电子疼痛评估工具的心理测量特性。
横断面心理测量研究。
英国大伦敦地区两家综合医院的六个老年医疗病房。
63名临床诊断为痴呆症的患者：平均年龄84岁（标准差6.7），59%为女性，69%居住在自己家中，64%为英国白人，77%为中度/重度痴呆。
对PainChek进行心理测量评估，这是一种结合人工智能、面部分析和智能手机技术的即时护理电子疼痛评估工具。在总共216次评估中，我们测试了PainChek在静息和运动后与晚期痴呆疼痛评估（PAINAD）评分之间的评分者间信度（IRR）（科恩kappa系数）、内部一致性（克朗巴赫alpha系数）和同时效度（皮尔逊系数）[在适当情况下为95%置信区间（95%CI）]。我们用痴呆症临终症状管理量表（SM-EOLD）（皮尔逊系数）评估收敛效度，用判别效度（静息与运动后）进行评估。
IRR在静息时为0.714（95%CI 0.562至0.81），运动后为0.817（95%CI 0.692至0.894）。内部一致性在静息时为0.755，运动后为0.833。与PAINAD的同时效度在静息时为0.528（95%CI 0.317至0.690），运动后为0.787（0.604至0.891）。与SM-EOLD的收敛效度在静息时为-0.555（95%CI -0.726至-0.318），运动后为-0.5644（95%CI -0.733至-0.331）。判别效度显著。
PainChek是综合医院中用于痴呆症患者的有效且可靠的疼痛评估工具。在该环境中实施还需要进一步考虑。
