马来西亚晚期痴呆疼痛评估(PAINAD)量表的多中心验证

Psych Pub Date : 2023-07-24 DOI:10.3390/psych5030052
H. Teh, In Jiann Tan, Hong Tak Lim, Y. Ho, C. Ng, Rosmahani Mohd Ali, Jia Nee Ling, W. C. Lim, Gordon Hwa Mang Pang, Hwee Hwee Chua, Faisal Norizan, Norazlina Ibrahim, Chin Eang Goh, Gin Wei Chai, Malarkodi Suppamutharwyam, Melinda Ang, Dyascynthia Musa, Sook Chin Chan, Nurulakmal Obet, Yan Xi Yew, Zhen Aun Yee, Ai Vuen Lee, Way Ti Ooi, H. K. Ho, Yee Leng Lee, Rohilin Justa, Yoong Wah Lee, Hwei Wern Tay, Kuo Zhau Teo, Nor Hakima Makhtar, Ungku Ahmad Ameen Ungku Mohd Zam
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引用次数: 0

摘要

晚期痴呆症患者的疼痛检测是具有挑战性的,因为他们无法口头表达他们正在经历的疼痛。晚期痴呆患者疼痛评估(PAINAD)是一种基于非语言表达的重度痴呆患者疼痛评估工具。本研究旨在对马来西亚重度痴呆患者进行疼痛评估的PAINAD进行结构验证。这是一项前瞻性横断面研究,于2022年4月27日至2022年10月28日在马来西亚的八家公立医院进行。以PAINAD量表为指标测试,以老年痴呆症不适量表(DS-DAT)和护士报告疼痛量表(NRPS)为参考测试进行结构效度评估和并发效度评估。研究对象的疼痛评估由两名评分员在休息和活动时同时进行。PAINAD评分由第一评分者决定,而DS-DAT和NRPS评分由第二评分者评估,并且他们对彼此的结果是盲目的,以防止偏见。在休息和活动时,PAINAD与DS-DAT和NRPS呈0.325 ~ 0.715的良好正相关,p值<0.05。在比较休息时和活动时、干预前和干预后的疼痛评分时,也显示出统计学上的显著差异。总之,PAINAD量表是马来西亚重度痴呆患者的可靠的观察者评价疼痛评估工具。它对活动和休息时、干预前后疼痛水平的变化也很敏感。
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Multi-Center Validation of Pain Assessment in Advanced Dementia (PAINAD) Scale in Malaysia
The detection of pain in persons with advanced dementia is challenging due to their inability to verbally articulate the pain they are experiencing. Pain Assessment in Advanced Dementia (PAINAD) is an observer-rated pain assessment tool developed based on non-verbal expressions of pain for persons with severe dementia. This study aimed to perform construct validation of PAINAD for pain assessment in persons with severe dementia in Malaysia. This was a prospective cross-sectional study conducted from 27 April 2022 to 28 October 2022 in eight public hospitals in Malaysia. The PAINAD scale was the index test, and the Discomfort Scale—Dementia of the Alzheimer Type (DS-DAT) and Nurse-Reported Pain Scale (NRPS) were the reference tests for construct and concurrent validity assessment. Pain assessment for the study subjects was performed by two raters concurrently at rest and during activity. The PAINAD score was determined by the first rater, whereas the DS-DAT and NRPS were assessed by the second rater, and they were blinded to each other’s findings to prevent bias. PAINAD showed good positive correlations ranging from 0.325 to 0.715 with DS-DAT and NRPS at rest and during activity, with a p-value of <0.05. It also demonstrated statistically significant differences when comparing pain scores at rest and during activity, pre- and post-intervention. In conclusion, the PAINAD scale is a reliable observer-rated pain assessment tool for persons with severe dementia in Malaysia. It is also sensitive to changes in the pain level during activity and at rest, pre- and post-intervention.
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