Which score most likely represents pain on the observational painad pain scale for patients with dementia
Journal of the American Medical Directors Association, 05/17/2012
Zwakhalen SMG et al. – Based on the findings of multiple available data sources, authors recommend that a pain assessment in advanced dementia (PAINAD) score of 2 or more can be used as an indicator of probable pain. A score of 1 is a sign to be attentive to possible pain. Future work may focus on cutoff scores for the presence of pain and severe pain in other frequently used pain tools, and on further development of methodology to assess cutoff scores.
Methods- Authors used data from multiple sources.
- They performed a literature review on PAINAD, performed secondary data analysis of a study examining psychometric properties of PAINAD in nursing home patients with dementia, and performed another study in nursing home patients with dementia specifically aimed at determining a cutoff score for PAINAD.
- Patients with dementia in long term care facilities.
- They related PAINAD scores (range 0 to 10) to (1) self–reported and proxy–reported pain by global clinical judgment and (2) scores on another pain assessment instrument (DOLOPLUS–2), and (3) they compared scores between painful and supposedly less painful conditions.
- Findings from this study showed that a cutoff value of 2 should serve as a trigger for a trial with pain treatment.
- Although the majority of patients scoring 1 or 0 were not in pain, pain could be ruled out.
