title: Introduction of a pain scale for palliative care patients with cognitive impairment.
abstract: OBJECTIVE
  To describe the development and introduction of a pain scale for patients with cognitive impairment who are admitted to homes for older people and nursing homes in the region of northwest Flanders in Belgium.
  
  
  METHODS
  A questionnaire comparing the Abbey and Pain Assessment in Advanced Dementia (PAINAD) scales was distributed in 17 homes; 185 care providers participated, evaluating 157 patients.
  
  
  RESULTS
  Approximately half of the care providers evaluated both scales as being good measures of pain and easy to use. Of the different items scored in both scales, care providers agreed upon three indicators as being most valuable to use for measuring pain: facial expression; vocalization; and body language.
  
  
  CONCLUSIONS
  The findings were not conclusive for the introduction of either Abbey or PAINAD. Based on the results, a simplified pain observation scale consisting of three items was developed. It has been introduced in the homes of the region and is being tested currently.
authors.affiliation: Palliative Care Network, Northwest Flanders, Diksmuidse Heirweg 647, B 8200 Bruges, Belgium. tvaniersel@pznwvl.be
authors.forename: Trudie
authors.initials: T
authors.lastname: van Iersel
authors.forename: Denise
authors.initials: D
authors.lastname: Timmerman
authors.forename: Arsene
authors.initials: A
authors.lastname: Mullie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001530:Belgium; D003072:Cognition Disorders / Q000150:complications*; D005149:Facial Expression; D005260:Female; D006801:Humans; D007697:Kinesics; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods; D015403:Nursing Evaluation Research; D009735:Nursing Homes; D015404:Nursing Methodology Research; D010146:Pain / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement / Q000379:methods* / Q000451:nursing / Q000592:standards; D010166:Palliative Care / Q000379:methods*; D010865:Pilot Projects; D012119:Respiration; D011795:Surveys and Questionnaires; D014175:Translating; D014705:Verbal Behavior