pain changes in a six point Likert scale, (4) a thermometer pain scale that measures overall degrees of pain.
A study performed by Horgas et al. (2009) evaluated reliability of NOPAIN. The study tested the association between NOPAIN and patient self-report and other pain rating procedures based on patient’s actions. 20 mentally alert and oriented patients and 20 mentally limited patients were participated in this study, and their daily activity was monitored and evaluated based on NOPAIN and other pain assessment tools. The study showed that NOPAIN has high reliability, and significant associations were found between NOPAIN and pain reported by the patients. The result proposed that NOPAIN was a suitable pain assessment tool and could be utilized to measure pain in older populations.
A second pain assessment tool is the Pain Assessment in Advanced Dementia (PAINAD). This pain scale is established to assist mentally challenged patients and patients who have limited ability to express their pain. The scoring is done based on observations of followings: “breathing, negative vocalization, facial expression, body language, and consolability, which means a sense of well-being”. Each of 5 sections includes a scale from 0 to 2. The recorder adds up the numbers from each 5 section at the end for a final score, which is can be up to 10. In other words, the total score ranges from 0-10 points. A possible interpretation of the scores is the following: 1-3 is mild pain, 4-6 is moderate pain, and 7-10 is severe pain. The patients can be observed under different conditions, such as at rest, during a pleasant activity, during caregiving, after the administration of pain medication (Jordan et al, 2011).
DeWaters et al (2008) conducted a study using PAINAD to assess pain in cognitively limited older adults and cognitively intact older adults, who were admitted in a hospital for a hip surgery due to fracture. 12 cognitively limited patients and 13 cognitively intact patients participated in this study. Numeric rating scale, observational assessment tool, and PAINAD were utilized to assess their pain level. Findings concluded that there was a high correlation between the PAINAD and a self-report pain scale, and it established the validity of PAINAD. In conclusion, the results showed that PAINAD had the validity and reliability as a pain assessment tool, and the study supported that PAINAD can be utilized as a pain measurement tool for hospitalized older populations who cannot express pain by themselves.
A final pain assessment tool is the Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). It is a behavioral assessment tool designed to improve the detection of pain in severe dementia. This tool includes following criteria: “facial expression, social, personality, mood, activity, body movement, physiological changes, eating, sleeping changes, vocal behaviors” (Chan et al, 2013). Pain is measured by checking each scale box based on...
