title: Cultural adaptation and reproducibility validation of the Brazilian Portuguese version of the Pain Assessment in Advanced Dementia (PAINAD-Brazil) scale in non-verbal adult patients.
abstract: OBJECTIVE
  To adapt the Pain Assessment in Advanced Dementia (PAINAD) scale to Brazilian Portuguese with respect to semantic equivalence and cultural aspects, and to evaluate the respective psychometric properties (validity, feasibility, clinical utility and inter-rater agreement).
  
  
  METHODS
  Two-stage descriptive, cross-sectional retrospective study involving cultural and semantic validation of the Brazilian Portuguese version of the scale, and investigation of its psychometric properties (validity, reliability and clinical utility). The sample consisted of 63 inpatients presenting with neurological deficits and unable to self-report pain.
  
  
  RESULTS
  Semantic and cultural validation of the PAINAD scale was easily achieved. The scale indicators most commonly used by nurses to assess pain were "Facial expression", "Body language" and "Consolability". The Brazilian Portuguese version of the scale has proved to be valid and accurate; good levels of inter-rater agreement assured reproducibility.
  
  
  CONCLUSIONS
  The scale has proved to be useful in daily routine care of hospitalized adult and elderly patients in a variety of clinical settings. Short application time, ease of use, clear instructions and the simplicity of training required for application were emphasized. However, interpretation of facial expression and consolability should be given special attention during pain assessment training.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Marcia Carla Morete
authors.initials: MC
authors.lastname: Pinto
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Fabiola Peixoto
authors.initials: FP
authors.lastname: Minson
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Ana Carolina Biagioni
authors.initials: AC
authors.lastname: Lopes
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Claudia Regina
authors.initials: CR
authors.lastname: Laselva
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D003704:Dementia / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods* / Q000592:standards; D011594:Psychometrics / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014177:Translations; D055815:Young Adult