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Pain in severe dementia: A comparison of a fine‐grained assessment approach to an observational checklist designed for clinical settings

BACKGROUND: Fine‐grained observational approaches to pain assessment (e.g. the Facial Action Coding System; FACS) are used to evaluate pain in individuals with and without dementia. These approaches are difficult to utilize in clinical settings as they require specialized training and equipment. Eas...

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Autores principales: Hadjistavropoulos, T., Browne, M.E., Prkachin, K.M., Taati, B., Ashraf, A., Mihailidis, A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5947563/
https://www.ncbi.nlm.nih.gov/pubmed/29359875
http://dx.doi.org/10.1002/ejp.1177
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author Hadjistavropoulos, T.
Browne, M.E.
Prkachin, K.M.
Taati, B.
Ashraf, A.
Mihailidis, A.
author_facet Hadjistavropoulos, T.
Browne, M.E.
Prkachin, K.M.
Taati, B.
Ashraf, A.
Mihailidis, A.
author_sort Hadjistavropoulos, T.
collection PubMed
description BACKGROUND: Fine‐grained observational approaches to pain assessment (e.g. the Facial Action Coding System; FACS) are used to evaluate pain in individuals with and without dementia. These approaches are difficult to utilize in clinical settings as they require specialized training and equipment. Easy‐to‐use observational approaches (e.g. the Pain Assessment Checklist for Limited Ability to Communicate‐II; PACSLAC‐II) have been developed for clinical settings. Our goal was to compare a FACS‐based fine‐grained system to the PACSLAC‐II in differentiating painful from non‐painful states in older adults with and without dementia. METHOD: We video‐recorded older long‐term care residents with dementia and older adult outpatients without dementia, during a quiet baseline condition and while they took part in a physiotherapy examination designed to identify painful areas. Videos were coded using pain‐related behaviours from the FACS and the PACSLAC‐II. RESULTS: Both tools differentiated between painful and non‐painful states, but the PACSLAC‐II accounted for more variance than the FACS‐based approach. Participants with dementia scored higher on the PACSLAC‐II than participants without dementia. CONCLUSION: The results suggest that easy‐to‐use observational approaches for clinical settings are valid and that there may not be any clinically important advantages to using more resource‐intensive coding approaches based on FACS. We acknowledge, as a limitation of our study, that we used as baseline a quiet condition that did not involve significant patient movement. In contrast, our pain condition involved systematic patient movement. Future research should be aimed at replicating our results using a baseline condition that involves non‐painful movements. SIGNIFICANCE: Examining older adults with and without dementia, a brief observational clinical approach was found to be valid and accounted for more variance in differentiating pain‐related and non‐pain‐related states than did a detailed time‐consuming fine‐grained approach.
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spelling pubmed-59475632018-05-17 Pain in severe dementia: A comparison of a fine‐grained assessment approach to an observational checklist designed for clinical settings Hadjistavropoulos, T. Browne, M.E. Prkachin, K.M. Taati, B. Ashraf, A. Mihailidis, A. Eur J Pain Original Articles BACKGROUND: Fine‐grained observational approaches to pain assessment (e.g. the Facial Action Coding System; FACS) are used to evaluate pain in individuals with and without dementia. These approaches are difficult to utilize in clinical settings as they require specialized training and equipment. Easy‐to‐use observational approaches (e.g. the Pain Assessment Checklist for Limited Ability to Communicate‐II; PACSLAC‐II) have been developed for clinical settings. Our goal was to compare a FACS‐based fine‐grained system to the PACSLAC‐II in differentiating painful from non‐painful states in older adults with and without dementia. METHOD: We video‐recorded older long‐term care residents with dementia and older adult outpatients without dementia, during a quiet baseline condition and while they took part in a physiotherapy examination designed to identify painful areas. Videos were coded using pain‐related behaviours from the FACS and the PACSLAC‐II. RESULTS: Both tools differentiated between painful and non‐painful states, but the PACSLAC‐II accounted for more variance than the FACS‐based approach. Participants with dementia scored higher on the PACSLAC‐II than participants without dementia. CONCLUSION: The results suggest that easy‐to‐use observational approaches for clinical settings are valid and that there may not be any clinically important advantages to using more resource‐intensive coding approaches based on FACS. We acknowledge, as a limitation of our study, that we used as baseline a quiet condition that did not involve significant patient movement. In contrast, our pain condition involved systematic patient movement. Future research should be aimed at replicating our results using a baseline condition that involves non‐painful movements. SIGNIFICANCE: Examining older adults with and without dementia, a brief observational clinical approach was found to be valid and accounted for more variance in differentiating pain‐related and non‐pain‐related states than did a detailed time‐consuming fine‐grained approach. John Wiley and Sons Inc. 2018-01-23 2018-05 /pmc/articles/PMC5947563/ /pubmed/29359875 http://dx.doi.org/10.1002/ejp.1177 Text en © 2018 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation‐EFIC® This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Hadjistavropoulos, T.
Browne, M.E.
Prkachin, K.M.
Taati, B.
Ashraf, A.
Mihailidis, A.
Pain in severe dementia: A comparison of a fine‐grained assessment approach to an observational checklist designed for clinical settings
title Pain in severe dementia: A comparison of a fine‐grained assessment approach to an observational checklist designed for clinical settings
title_full Pain in severe dementia: A comparison of a fine‐grained assessment approach to an observational checklist designed for clinical settings
title_fullStr Pain in severe dementia: A comparison of a fine‐grained assessment approach to an observational checklist designed for clinical settings
title_full_unstemmed Pain in severe dementia: A comparison of a fine‐grained assessment approach to an observational checklist designed for clinical settings
title_short Pain in severe dementia: A comparison of a fine‐grained assessment approach to an observational checklist designed for clinical settings
title_sort pain in severe dementia: a comparison of a fine‐grained assessment approach to an observational checklist designed for clinical settings
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5947563/
https://www.ncbi.nlm.nih.gov/pubmed/29359875
http://dx.doi.org/10.1002/ejp.1177
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