Pain Assessment for the Dementing Elderly (PADE): reliability and validity of a new measure.

Abstract

OBJECTIVES:

To establish the reliability and validity of a measure to assess pain in individuals with advanced dementia.

DESIGN:

Sixty-five residents of long-term care facilities were assessed using a new rating tool, the Pain Assessment for the Dementing Elderly (PADE), in two separate studies: (1) Residents were assessed simultaneously by two different raters, at Time 1 and 2, to establish interrater reliability, stability, and internal consistency. (2) Validity was established by assessing the correlation between an agitation scale and the PADE; by comparing groups with pain as a significant clinical factor (as assessed by an independent rater) versus not a significant factor, and by assessing individuals receiving versus not receiving psychoactive medications.

SETTING:

Four different long-term care facilities, three skilled nursing facilities, and a locked dementia assisted-living facility.

PARTICIPANTS:

Twenty-five residents of long-term care facilities with advanced levels of dementia in Study 1, and 40 residents with similar level of dementia in Study 2; 42% of the total sample were rated as having significant painful conditions.

MEASUREMENTS:

For Study 1, the PADE was administered; for Study 2, the PADE and the Cohen-Mansfield Agitation Inventory (CMAI) were administered.

RESULTS:

Reliability coefficients were adequate (interrater = 0.54-0.95; stability = 0.70-0.98; and internal consistency = 0.24-0.88). Validity coefficients were likewise encouraging, with the PADE demonstrating the expected relationship with a measure of agitation. The PADE also differentiated between groups that were independently judged to suffer clinically problematic pain versus those who were not.

CONCLUSION:

The PADE is a reliable and valid tool to assess pain in dementing elderly residents of long-term care facilities.

• Authors: Michael R Villanueva, Tricia L Smith, Janelle S Erickson, Angela C Lee, Clifford M Singer
• Journal: Journal of the American Medical Directors Association (J Am Med Dir Assoc) 2003 Jan-Feb Vol. 4 Issue 1 Pg. 1-8 ISSN: 1525-8610 [Print] United States
• PMID: 12807590 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Aged, 80 and over
• Confidence Intervals
• Dementia
• Female
• Humans
• Long-Term Care
• Male
• Pain (diagnosis)
• Pain Measurement (methods)
• Reproducibility of Results