title: A comparison between behavioral and verbal report pain assessment tools for use with residents in long term care.
abstract: The purpose of this study was twofold: (1) to evaluate four pain assessment tools for use with long-term care (LTC) residents who were both able and not able to verbally report their pain; and (2) to assess whether pain behaviors displayed by LTC residents vary as a function of ability to self-report pain. We examined the differences between these two groups of residents in terms of specific pain behaviors assessed through the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) and Pain Assessment in the Communicatively Impaired (PACI). We also examined the interrater reliability, and concurrent and construct validity of these two behavioral observation tools and the concurrent and construct validity of the two verbal report tools. Data were collected from a convenience sample of 338 residents from six LTC homes. The interrater reliabilities for the two behavioral observation tools were good, and concurrent validity was supported for all four pain assessment tools. Pain behaviors, as assessed by the PACSLAC and PACI, varied as a function of resident ability to verbally report pain. Residents with inability to self-report pain are more nonverbally responsive, although certain behaviors (such as guarding and touching the affected area) are seen more frequently in those capable of self-report. Our data also provide psychometric support for the assessment methods used in this study.
authors: School of Nursing, McMaster University, Hamilton, Ontario. Electronic address: kaasal@mcmaster.ca.
authors: Sharon
authors: S
authors: Kaasalainen
authors: School of Nursing, McMaster University, Hamilton, Ontario; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
authors: Noori
authors: N
authors: Akhtar-Danesh
authors: Department of Psychology and Centre on Aging and Health, University of Regina, Maastricht, The Netherlands.
authors: Thomas
authors: T
authors: Hadjistavropoulos
authors: Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.
authors: Sandra
authors: S
authors: Zwakhalen
authors: University of Laval, Quebec, Quebec, Canada.
authors: Rene
authors: R
authors: Verreault
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001519:Behavior; D003704:Dementia / Q000451:nursing; D005260:Female; D005851:Geriatric Nursing / Q000379:methods* / Q000592:standards; D006801:Humans; D008134:Long-Term Care / Q000379:methods* / Q000592:standards; D008297:Male; D015588:Observer Variation; D010146:Pain / Q000451:nursing* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods / Q000451:nursing* / Q000706:statistics & numerical data; D011594:Psychometrics / Q000379:methods / Q000592:standards; D015203:Reproducibility of Results; D057566:Self Report; D014705:Verbal Behavior