A Psychophysical Investigation of the Facial Action Coding System as an Index of Pain Variability among Older Adults with and without Alzheimer's Disease

Lints-Martindale, Amanda C.; Hadjistavropoulos, Thomas; Barber, Bruce; Gibson, Stephen

doi:10.1111/j.1526-4637.2007.00358.x

Cited by 90 publications

(71 citation statements)

References 25 publications

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“…[22][23][24][25][26][27] Central to pain assessment are the self-report of pain and/or the direct observation of pain-related behaviours. Seniors who present with mild to moderate dementia tend to be able to provide valid self-reports of pain.…”

Section: The Assessment Of Painmentioning

confidence: 99%

Practice Guidelines for Assessing Pain in Older Persons with Dementia Residing in Long-Term Care Facilities

Hadjistavropoulos

Fitzgerald²,

Marchildon³

2010

Physiotherapy Canada

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Purpose: Frail patients with dementia most frequently present with musculoskeletal pain and mobility concerns; therefore, physiotherapy interventions for this population are likely to be of great benefit. However, physiotherapists who work with older adults with dementia confront a considerable challenge: the communication impairments that characterize dementia make it difficult to assess pain and determine its source. For an effective physiotherapy programme to be implemented, valid pain assessment is necessary. This paper is intended to provide practice guidelines for pain assessment among older persons with dementia. Summary of Key Points: Over the last several years, there has been tremendous research progress in this area. While more research is needed, several promising assessment methodologies are available. These methodologies most often involve the use of observational checklists to record specific pain behaviours. Recommendations: We encourage the ongoing and regular evidence-based pain assessment of older persons with dementia, using standardized procedures. Without regular and systematic assessment, pain problems will often go undetected in this population. Given the need for systematic pain assessment and intervention for long-term care populations with mobility concerns and muculoskeletal pain problems, we call for increased involvement of physical therapists in long-term care facilities.Key Words: Alzheimer's disease, assessment, dementia, long-term care, older adults, painHadjistavropoulos T, Dever Fitzgerald T, Marchildon GP. Practice guidelines for assessing pain in older persons with dementia residing in long-term care facilities. Physiother Can. 2010;62:104-113. RÉ SUMÉObjectif : Les patients de santé fragile atteints de dé mence sont les plus sujets aux douleurs musculosquelettiques et aux problè mes de mobilité . Par consé quent, les interventions en physiothé rapie apporteront sans doute de grands bienfaits à cette clientè le. Toutefois, les physiothé rapeutes travaillant auprè s des personnes â gé es atteintes de dé mence doivent faire face à un dé fi de taille : la dé gradation des capacité s de communication caracté risant la dé mence fait en sorte qu'il est difficile d'é valuer la douleur et d'en dé terminer la source. Pour qu'un programme efficace de physiothé rapie puisse ê tre mis en oeuvre, une é valuation valide de la douleur doit ê tre ré alisé e. Cette documentation tente de proposer des directives de pratique pour l'é valuation de la douleur chez les personnes â gé es atteintes de dé mence. Ré sumé des points clé s : Au cours des derniè res anné es, des progrè s considé rables ont é té ré alisé s au chapitre de la recherche dans ce secteur. Mê me si plus de recherche est né cessaire, plusieurs mé thodes d'é valuation prometteuses sont disponibles. Ces mé thodologies font souvent appel à l'utilisation de listes de vé rification des observations comprenant la consignation de comportements douloureux particuliers. Recommandations : Nous encourageons l'é valuation continue ...

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Section: The Assessment Of Painmentioning

confidence: 99%

Practice Guidelines for Assessing Pain in Older Persons with Dementia Residing in Long-Term Care Facilities

Hadjistavropoulos

Fitzgerald²,

Marchildon³

2010

Physiotherapy Canada

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“…Current research supports this approach, which is why we have developed the electronic Pain Assessment Tool (ePAT), a novel instrument of great potential to transform the process of pain assessment in dementia [29, 32, 33]. The ePAT is a point-of-care tool that uses a hybrid model: automated facial recognition and analysis, digitization, and clinical observations [33].…”

Section: Introductionmentioning

confidence: 99%

Psychometric Evaluation of the Electronic Pain Assessment Tool: An Innovative Instrument for Individuals with Moderate-to-Severe Dementia

Atee

Hoti

Hughes

2017

Dement Geriatr Cogn Disord

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Background/Aims: Pain is common in aged care residents with dementia; yet it often goes undetected. A novel tool, the electronic Pain Assessment Tool (ePAT), was developed to address this challenging problem. We investigated the psychometric properties of the ePAT. Methods: In a 10-week prospective observational study, the ePAT was evaluated by comparison against the Abbey Pain Scale (APS). Pain assessments were blindly co-performed by the ePAT rater against the nursing staff of two residential aged care facilities. The residents were assessed twice by each rater: at rest and following movement. Results: The study involved 34 residents aged 85.5 ± 6.3 years, predominantly with severe dementia (Psychogeriatric Assessment Scale – Cognitive Impairment score = 19.7 ± 2.5). Four hundred paired assessments (n = 204 during rest; n = 196 following movement) were performed. Concurrent validity (r = 0.911) and all reliability measures (κ_w = 0.857; intraclass correlation coefficient = 0.904; α = 0.950) were excellent, while discriminant validity and predictive validity were good. Conclusion: The ePAT is a suitable tool for the assessment of pain in this vulnerable population.

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“…84–86 Currently available behavioral assessment tools, such as DOLOPLUS-2 87 and PACSLAC, 88 which rely on non-verbal cues, can be used for the assessment of pain in patients with dementia or cognitive impairment, especially in nursing homes. 89 These tools, however, are underdeveloped and have poor psychometric properties. 90 …”

Section: Gaps/challenges In Current Geriatric Rheumatology Clinical Carementioning

confidence: 99%

Gaps in Aging Research as it Applies to Rheumatologic Clinical Care

Makris

Misra

Yung

2017

Clinics in Geriatric Medicine

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Synopsis The incidence and prevalence of rheumatologic conditions is increasing and the Rheumatology workforce must be aware of aging-specific issues. In this article, we review specific barriers to our understanding of the biology of aging and aging-related mechanisms that may underlie development of rheumatologic diseases in older adults. We summarize gaps in the assessment, outcomes measurement and treatment of these diseases in this unique population. Lastly, we highlight potential solutions to these barriers and suggest possible ways to bridge the gap, from a research and education standpoint, so we can be better prepared to effectively manage older adults with rheumatologic conditions.

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A Psychophysical Investigation of the Facial Action Coding System as an Index of Pain Variability among Older Adults with and without Alzheimer's Disease

Cited by 90 publications

References 25 publications

Practice Guidelines for Assessing Pain in Older Persons with Dementia Residing in Long-Term Care Facilities

Practice Guidelines for Assessing Pain in Older Persons with Dementia Residing in Long-Term Care Facilities

Psychometric Evaluation of the Electronic Pain Assessment Tool: An Innovative Instrument for Individuals with Moderate-to-Severe Dementia

Gaps in Aging Research as it Applies to Rheumatologic Clinical Care

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