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.
Fuchs-Lacelle
Shannon
S
Department of Psychology, University of Regina, Saskatchewan, Canada.
Hadjistavropoulos
Thomas
T
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