title: Evidence-based development and initial validation of the pain assessment checklist for seniors with limited ability to communicate-II (PACSLAC-II).
abstract: OBJECTIVE
  Our goal was to develop and validate, based on theoretical and empirical knowledge, the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-II), a shorter tool that would improve on the PACSLAC, while addressing limitations of the original version.
  
  
  METHODS
  The PACSLAC was revised based on the relevant clinical and theoretical literature. Psychometric properties and clinical utility of the resulting 31-item PACSLAC-II were examined. Specifically, the PACSLAC-II was used to assess pain based on video footage of long-term care (LTC) residents with dementia undergoing painful procedures as part of routine care. Its ability to discriminate pain from non-pain-related states was compared with that of preexisting pain assessment tools using archival data. A second phase involved the use of the PACSLAC and PACSLAC-II by LTC staff to solicit feedback from health care providers. Mixed-methods analysis of this feedback was conducted.
  
  
  RESULTS
  The PACSLAC-II demonstrated satisfactory reliability, excellent validity, and ability to differentiate between pain and nonpain states. The PACSLAC-II also accounted for unique variance in differentiating between pain and nonpain states, even after controlling for the preexisting tools combined, including the PACSLAC. The PACSLAC-II was also preferred by many LTC nurses and care aides, because of its length and condensed nature, which was thought to facilitate documentation and greater efficiency in pain management.
  
  
  CONCLUSIONS
  Findings indicate that the empirical and theoretically driven revisions to the PACSLAC led to improved ability to differentiate between pain and nonpain states, while retaining its clinical utility.
authors.affiliation: *Department of Psychology and Centre on Aging and Health, University of Regina, Regina, SK †Department of Clinical Health Psychology, Faculty of Medicine, University of Manitoba, MB, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Chan
authors.forename: Thomas
authors.initials: T
authors.lastname: Hadjistavropoulos
authors.forename: Jaime
authors.initials: J
authors.lastname: Williams
authors.forename: Amanda
authors.initials: A
authors.lastname: Lints-Martindale
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003147:Communication Disorders / Q000150:complications*; D003704:Dementia / Q000150:complications; D005260:Female; D006282:Health Personnel; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009068:Movement; D009483:Neuropsychological Tests; D010146:Pain / Q000150:complications* / Q000175:diagnosis*; D010147:Pain Measurement / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D014741:Video Recording