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The Pain Assessment in Impaired Cognition scale (PAIC15): a multidisciplinary and international approach to develop and test a meta-tool for pain assessment in impaired cognition, especially dementia

Kunz, M; de Waal, MW; Achterberg, WP; Gimenez-Llort, L; Lobbezoo, F; Sampson, EL; van Dalen-Kok, AH; ... Lautenbacher, S; + view all (2020) The Pain Assessment in Impaired Cognition scale (PAIC15): a multidisciplinary and international approach to develop and test a meta-tool for pain assessment in impaired cognition, especially dementia. European Journal of Pain , 24 (1) pp. 192-208. 10.1002/ejp.1477. Green open access

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Abstract

BACKGROUND: Over the last decades, a considerable number of observational scales have been developed to assess pain in persons with dementia. The time seems ripe now to build on the knowledge and expertise implemented in these scales to form an improved, "best-of" meta-tool. The EU-COST initiative "Pain in impaired cognition, especially dementia" aimed to do this by selecting items out of existing observational scales and critically re-assessing their suitability to detect pain in dementia. This paper reports on the final phase of this collaborative task. // METHODS: Items from existing observational pain scales were tested for "frequency of occurrence (item difficulty)", "reliability", and "validity". This psychometric testing was carried out in eight countries, in different healthcare settings, and included clinical as well as experimental pain conditions. // RESULTS: Across all studies, 587 persons with dementia, 27 individuals with intellectual disability, 12 Huntington's disease patients, and 59 cognitively healthy controls were observed during rest and movement situations or while receiving experimental pressure pain, respectively. The psychometric outcomes for each item across the different studies were evaluated within an international and multidisciplinary team of experts and led a final selection of 15 items (5x facial expressions, 5x body movements, 5x vocalizations). // CONCLUSIONS: The final list of 15 observational items have demonstrated psychometric quality and clinical usefulness both in their former scales and in the present international evaluation; accordingly, they qualified twice to form a new internationally agreed-on meta-tool for Pain Assessment in Impaired Cognition, the PAIC-15 scale.

Type: Article
Title: The Pain Assessment in Impaired Cognition scale (PAIC15): a multidisciplinary and international approach to develop and test a meta-tool for pain assessment in impaired cognition, especially dementia
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/ejp.1477
Publisher version: https://doi.org/10.1002/ejp.1477
Language: English
Additional information: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10081368
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