Clinimetric properties of the electronic Pain Assessment Tool (ePAT) for aged-care residents with moderate to severe dementia

Background/Aims: Pain is common in aged care residents with dementia; yet it often goes undetected. A novel tool, the electronic Pain Assessment Tool (ePAT), was developed to address this challenging problem. We investigated the psychometric properties of the ePAT. Methods: In a 10-week prospective observational study, the ePAT was evaluated by comparison against the Abbey Pain Scale (APS). Pain assessments were blindly co-performed by the ePAT rater against the nursing staff of two residential aged care facilities. The residents were assessed twice by each rater: at rest and following movement. Results: The study involved 34 residents aged 85.5 ± 6.3 years, predominantly with severe dementia (Psychogeriatric Assessment Scale – Cognitive Impairment score = 19.7 ± 2.5). Four hundred paired assessments (n = 204 during rest; n = 196 following movement) were performed. Concurrent validity (r = 0.911) and all reliability measures (κw = 0.857; intraclass correlation coefficient = 0.904; α = 0.950) were excellent, while discriminant validity and predictive validity were good. Conclusion: The ePAT is a suitable tool for the assessment of pain in this vulnerable population.

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421 - Prevalence of Pain in Dementia Subtypes: Data from a National Sample of Aged Care Residents in Australia

International Psychogeriatrics ◽

10.1017/s1041610221001800 ◽

2021 ◽

Vol 33 (S1) ◽

pp. 43-43

Author(s):

Atee M ◽

Morris T ◽

Macfarlane S ◽

Cunningham C

Keyword(s):

Pain Assessment ◽

Severe Pain ◽

Assessment Tool ◽

National Sample ◽

Aged Care ◽

Cross Sectional Study ◽

Residential Aged Care ◽

Cross Sectional ◽

Prevalence Of Pain ◽

The Impact

Background:Pain is poorly identified in dementia due to complete or partial loss in communication, which is associated with progressive cognitive impairment. If it goes untreated, pain can lead to behavioral disturbances (e.g., agitation/aggression), delirium, inappropriate pharmacotherapy (e.g., psychotropics), hospitalizations and caregiver distress. There are limited prevalence data in the literature on pain in dementia subtypes.Objective:This study aims to investigate the prevalence and intensity of pain in various dementia subtypes in aged care residents living with dementia (RLWD), using a technology-driven pain assessment tool.Methods:A 1-year retrospective cross-sectional study was conducted on the presence and intensity of pain in referrals to Dementia Support Australia from residential aged care homes (RACHs), using PainChek®. PainChek® is a pain assessment tool that uses artificial intelligence algorithms (e.g., automated facial recognition and analysis) to identify facial expressions indicative of pain in conjunction with other digital checklists of pain behaviors such as vocalization and movement cues. Presence and intensity of pain were identified using PainChek® categories (scores): no pain (0-6), mild pain (7-11), moderate pain (12-15) and severe pain (16-42).Results:During the study period (01/11/2017-31/10/2018), a sample of 479 referrals (age: 81.9 ± 8.3 years old; 55.5% female) from 370 RACHs with Alzheimer’s disease (AD; 40.9%), vascular dementia (VaD; 12.7%), mixed dementia (MD; 5.9%), dementia with Lewy body (DLB; 2.9%), and frontotemporal dementia (FTD; 2.3%) were examined. Pain was prevalent in two-thirds (65.6%) of the referrals with almost half (48.4%) of these categorized as experiencing moderate-severe pain. MD and those with DLB (78.6% each) shared the highest prevalence of pain, followed by AD (64.3%) > VaD (62.3%) > FTD (54.6%). Prevalence of severe pain was as follow: MD (17.9%) > AD (12.3%) > VaD (11.5%) > FTD (9.1%) > DLB (7.1%).Conclusion:To date, this is the largest study that presented data on pain prevalence and intensity in major dementia subtypes in the RACH setting. Moderate-severe pain is highly prevalent in RLWD, which appears to differ by dementia subtypes. This may reveal the impact of neuropathological etiology of those subtypes on the neurobiology of pain.Word count:344 words

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PO-0900 Translation Comfortneo – A Pain Assessment Tool

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-307384.1523 ◽

2014 ◽

Vol 99 (Suppl 2) ◽

pp. A545.2-A545

Author(s):

R Stenkjaer ◽

M Andersen ◽

M Scheutz ◽

Y Hundrup

Keyword(s):

Pain Assessment ◽

Assessment Tool

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Prospective Study Evaluating a Pain Assessment Tool in a Postoperative Environment: Protocol for Algorithm Testing and Enhancement (Preprint)

10.2196/preprints.17783 ◽

2020 ◽

Author(s):

Emad Kasaeyan Naeini ◽

Mingzhe Jiang ◽

Elise Syrjälä ◽

Michael-David Calderon ◽

Riitta Mieronkoski ◽

...

Keyword(s):

Electrical Activity ◽

Pain Assessment ◽

Assessment Tool ◽

Elective Surgery ◽

Electrodermal Activity ◽

Vital Signs ◽

Assessment Tools ◽

Second Phase ◽

Moderate Pain ◽

Management Interventions

BACKGROUND Assessment of pain is critical to its optimal treatment. There is a high demand for accurate objective pain assessment for effectively optimizing pain management interventions. However, pain is a multivalent, dynamic, and ambiguous phenomenon that is difficult to quantify, particularly when the patient’s ability to communicate is limited. The criterion standard of pain intensity assessment is self-reporting. However, this unidimensional model is disparaged for its oversimplification and limited applicability in several vulnerable patient populations. Researchers have attempted to develop objective pain assessment tools through analysis of physiological pain indicators, such as electrocardiography, electromyography, photoplethysmography, and electrodermal activity. However, pain assessment by using only these signals can be unreliable, as various other factors alter these vital signs and the adaptation of vital signs to pain stimulation varies from person to person. Objective pain assessment using behavioral signs such as facial expressions has recently gained attention. OBJECTIVE Our objective is to further the development and research of a pain assessment tool for use with patients who are likely experiencing mild to moderate pain. We will collect observational data through wearable technologies, measuring facial electromyography, electrocardiography, photoplethysmography, and electrodermal activity. METHODS This protocol focuses on the second phase of a larger study of multimodal signal acquisition through facial muscle electrical activity, cardiac electrical activity, and electrodermal activity as indicators of pain and for building predictive models. We used state-of-the-art standard sensors to measure bioelectrical electromyographic signals and changes in heart rate, respiratory rate, and oxygen saturation. Based on the results, we further developed the pain assessment tool and reconstituted it with modern wearable sensors, devices, and algorithms. In this second phase, we will test the smart pain assessment tool in communicative patients after elective surgery in the recovery room. RESULTS Our human research protections application for institutional review board review was approved for this part of the study. We expect to have the pain assessment tool developed and available for further research in early 2021. Preliminary results will be ready for publication during fall 2020. CONCLUSIONS This study will help to further the development of and research on an objective pain assessment tool for monitoring patients likely experiencing mild to moderate pain. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17783

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Improving the Quality of Care for Acute Pain Management in Recovery Room at the Georgetown Public Hospital Corporation

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2019/v30i1230258 ◽

2019 ◽

pp. 13-14

Author(s):

Dorette Husbands-Anderson ◽

Jennifer Szerb ◽

Alexandra Harvey

Keyword(s):

Pain Management ◽

Pain Assessment ◽

Health Care Professionals ◽

Assessment Tool ◽

Standards Of Care ◽

Average Dose ◽

Management Intervention ◽

Pain Medications ◽

Post Operative Pain ◽

Pain Intervention

Objectives: To observe the method of pain assessment and pain management intervention performed by nurses in the PACU. Methods and Design: A QI prospective observational study was conducted to observe nurse’s pain assessment and management of thirty (30) patients from the time of PACU admission to discharge. The sample size was determined using the sealed envelope power calculator. Data Collection Included: patients demographics, the method and frequency of pain assessments as well as modalities of the pain intervention and the type and average dose of pain medications administered by PACU nurses. Data analysis was done using Microsoft excel. Results: No validated pain assessment tool was used in the PACU. The majority of patients 67%, n=20) had no pain assessments or pain interventions. When performed, the frequency of pain assessments recorded were low, 70% of patients had 1-2 assessments. The principal pain management intervention was pharmacological with the use of opioids, accounting for 96%. Conclusion: Post-operative pain management in the PACU at GPHC does not meet accepted standards of care. More frequent nursing pain assessment using a validated pain assessment tool is required. Monotherapy with the opioid was the main pain intervention for pain management. Recommendations: Effective pain management begins with the appropriate pain assessment; therefore pain management education programs for health care professionals are essential. Also, the implementation of a standardized pain assessment tool, a standardized post anesthetic order sheet with a multimodal approach to pain management and restructuring the post-anesthetic record to allow for documentation of pain assessment will greatly improve pain management in the PACU.

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Development of a spiritual pain assessment sheet for terminal cancer patients: Targeting terminal cancer patients admitted to palliative care units in Japan

Palliative & Supportive Care ◽

10.1017/s147895150606024x ◽

2006 ◽

Vol 4 (2) ◽

pp. 179-188 ◽

Cited By ~ 5

Author(s):

KEIKO TAMURA ◽

KAORI ICHIHARA ◽

EIKO MAETAKI ◽

KEIKO TAKAYAMA ◽

KUMI TANISAWA ◽

...

Keyword(s):

Palliative Care ◽

Cancer Patients ◽

Pain Assessment ◽

Assessment Tool ◽

Three Dimensions ◽

Terminal Cancer ◽

Philosophical Perspective ◽

Terminal Cancer Patients ◽

Assessment Sheet ◽

Palliative Care Units

Objective: This research explores the potential benefit of a spiritual pain assessment sheet to clinical practice. With spiritual pain defined as “pain caused by extinction of the being and meaning of the self,” the spiritual pain assessment sheet was developed by Hisayuki Murata from his conceptual framework reflecting the three dimensions of a human being as a being founded on temporality, a being in relationship, and a being with autonomy. The assessment sheet was developed from reviews of the literature and examinations from a philosophical perspective on the structure of spiritual pain.Methods: Patients admitted to palliative care units in Japan were interviewed using the assessment sheet. The responses were analyzed qualitatively. The usefulness of the assessment sheet and the burden placed on the patients by its use were also investigated.Results: The spiritual pain elucidated by the assessment sheet was the same as that revealed in the earlier research of Morita. The patients reported that they did not find the use of the assessment sheet a burden, and more than half reported that it was useful. The burden of the assessment sheet on the subjects was thus determined to be low. Positive feedback on the assessment sheet was also received from the nurses who conducted the patient interviews, who said the assessment sheet made it easier to talk with the patients about their spiritual pain.Significance of research: The research results indicate that the spiritual pain assessment sheet provided an appropriate assessment of spiritual pain among terminal cancer patients, showing that such a sheet could be used as an assessment tool in the future.

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The cardiac analgesic assessment scale (CAAS): a pain assessment tool for intubated and ventilated children after cardiac surgery

Pediatric Anesthesia ◽

10.1046/j.1460-9592.2003.01241.x ◽

2004 ◽

Vol 14 (4) ◽

pp. 336-343 ◽

Cited By ~ 18

Author(s):

Pertti Suominen ◽

Chelsea Caffin ◽

Sophie Linton ◽

Dianne McKinley ◽

Philip Ragg ◽

...

Keyword(s):

Cardiac Surgery ◽

Pain Assessment ◽

Assessment Tool ◽

Assessment Scale

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European Palliative Care Research Center Collaborative Pain Assessment Tool

PsycTESTS Dataset ◽

10.1037/t12128-000 ◽

2011 ◽

Author(s):

Peter M. Fayers ◽

◽

Marianne J. Hjermstad ◽

Pål Klepstad ◽

Jon Håvard Loge ◽

...

Keyword(s):

Palliative Care ◽

Pain Assessment ◽

Assessment Tool ◽

Research Center ◽

Care Research

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Breakthrough Pain Assessment Tool

PsycTESTS Dataset ◽

10.1037/t45232-000 ◽

2014 ◽

Author(s):

Katherine Webber ◽

Andrew N. Davies ◽

Giovambattista Zeppetella ◽

Martin R. Cowie

Keyword(s):

Pain Assessment ◽

Assessment Tool ◽

Breakthrough Pain

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Pain Assessment and Management in Critically Ill Intubated Patients: a Retrospective Study

American Journal of Critical Care ◽

10.4037/ajcc2004.13.2.126 ◽

2004 ◽

Vol 13 (2) ◽

pp. 126-136 ◽

Cited By ~ 112

Author(s):

Céline Gélinas ◽

Martine Fortier ◽

Chantal Viens ◽

Lise Fillion ◽

Kathleen Puntillo

Keyword(s):

Pain Management ◽

Critically Ill ◽

Pain Assessment ◽

Assessment Tool ◽

Quebec City ◽

Pharmacological Interventions ◽

Relieve Pain ◽

Self Reports ◽

Data Collection Instrument ◽

Pain Documentation

• Background Little research has been done on pain assessment in critical care, especially in patients who cannot communicate verbally.• Objectives To describe (1) pain indicators used by nurses and physicians for pain assessment, (2) pain management (pharmacological and nonpharmacological interventions) undertaken by nurses to relieve pain, and (3) pain indicators used for pain reassessment by nurses to verify the effectiveness of pain management in patients who are intubated.• Methods Medical files from 2 specialized healthcare centers in Quebec City, Quebec, were reviewed. A data collection instrument based on Melzack’s theory was developed from existing tools. Pain-related indicators were clustered into nonobservable/subjective (patients’ self-reports of pain) and observable/objective (physiological and behavioral) categories.• Results A total of 183 pain episodes in 52 patients who received mechanical ventilation were analyzed. Observable indicators were recorded 97% of the time. Patients’ self-reports of pain were recorded only 29% of the time, a practice contradictory to recommendations for pain assessment. Pharmacological interventions were used more often (89% of the time) than nonpharmacological interventions (<25%) for managing pain. Almost 40% of the time, pain was not reassessed after an intervention. For reassessments, observable indicators were recorded 66% of the time; patients self-reports were recorded only 8% of the time.• Conclusions Pain documentation in medical files is incomplete or inadequate. The lack of a pain assessment tool may contribute to this situation. Research is still needed in the development of tools to enhance pain assessment in critically ill intubated patients.

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