title: [Assessment of pain in advanced dementia. Construct validity of the German PAINAD].
abstract: BACKGROUND
  The observation scale PAINAD (pain assessment in advanced dementia) is composed of five behavioral categories: breathing, vocalization, facial expression, body language, and consolability. The present study investigates the construct validity of the German version.
  
  
  METHODS
  We conducted a prospective one-dimensional observation study with repeated measurements (t(1)=pretreatment, t(2)=2 h posttreatment, t(3)=24 h posttreatment). The sample consisted of 12 verbally noncommunicative demented inpatients with severe comorbidity treated in three geriatric clinics. Their age was M=84.3 years (SD=4.4) on the average. Ten of them were female. Inclusion criteria were pain-related physical illness and observed pain behavior. Every patient was treated with analgesics after t(1). After t(2) the medication was discontinued in five patients until t(3). Nurses documented the PAINAD scores after an observation period of 2 min during routine care.
  
  
  RESULTS
  Pain behavior at t(2) diminished considerably displaying a large effect size. Scores continued to be low at t(3) only in the sample with continued medication. Scores in the other part of the sample returned to initial values.
  
  
  CONCLUSIONS
  The data demonstrate that pain medication strongly impacts the pain behavior of demented patients. The outcome supports the assumption that PAINAD really measures pain.
authors.affiliation: Institut für Medizinische Psychologie, Philipps-Universität, Bunsenstrasse 3, 35037 Marburg. basler@med.uni-marburg.de
authors.forename: H D
authors.initials: HD
authors.lastname: Basler
authors.forename: D
authors.initials: D
authors.lastname: Hüger
authors.forename: R
authors.initials: R
authors.lastname: Kunz
authors.forename: J
authors.initials: J
authors.lastname: Luckmann
authors.forename: A
authors.initials: A
authors.lastname: Lukas
authors.forename: T
authors.initials: T
authors.lastname: Nikolaus
authors.forename: M S
authors.initials: MS
authors.lastname: Schuler
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D003704:Dementia / Q000503:physiopathology*; D005858:Germany; D006801:Humans; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D015203:Reproducibility of Results
chemical_list: D000700:Analgesics