Development and preliminary validation of the pain assessment checklist for seniors with limited ability to communicate (PACSLAC).
The purpose of this study, conducted in three phases, was to develop a clinically useful observational tool (i.e., the Pain Assessment Checklist for Seniors With Limited Ability to Communicate [PACSLAC]) to assess pain in seniors with severe dementia. In Phase 1, professional caregivers of seniors with severe dementia were interviewed in order to generate a list of pain-related behaviors that are characteristic of care recipients living in long-term-care facilities. Based on a systematic examination of interview transcripts by experienced researchers and an independent coder, a behavioral checklist (i.e., the initial version of the PACSLAC) was developed. The checklist items were organized into conceptually based subscales (e.g., facial expressions, activity/body movement). Phase 2 focused on an assessment of the internal consistency of the checklist (alpha =.92). Following an item analysis, the subscales of the PACSLAC (Social/Personality/Mood Indicators, Facial Expressions, Activity/Body Movement, and Physiological Indicators/Eating/Sleeping Changes/Vocal Behaviors) were found to be internally consistent. Phase 3 focused on a preliminary validation of the PACSLAC. Analyses suggest that the PACSLAC discriminated among pain events (during which there was a clear and recognizable cause for the patients' pain), events during which patients were experiencing nonpainful distress, and situations during which patients were calm.
Department of Psychology, University of Regina, Saskatchewan, Canada.
Shannon
S
Fuchs-Lacelle
Thomas
T
Hadjistavropoulos
D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression; D001291:Attitude of Health Personnel; D003147:Communication Disorders / Q000150:complications*; D003704:Dementia / Q000150:complications*; D016002:Discriminant Analysis; D005149:Facial Expression; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D007697:Kinesics; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods / Q000592:standards; D015403:Nursing Evaluation Research; D010146:Pain / Q000150:complications / Q000175:diagnosis*; D010147:Pain Measurement / Q000379:methods* / Q000592:standards; D011594:Psychometrics; D012680:Sensitivity and Specificity; D012919:Social Behavior; D011795:Surveys and Questionnaires; D014705:Verbal Behavior