A scale to measure pain in non-verbally communicating older patients: The EPCA-2

Morello, Rémy; Jean, Alain; Alix, Michel; Sellin-Peres, Dominique; Fermanian, Jacques

doi:10.1016/j.pain.2007.03.007

Cited by 71 publications

(50 citation statements)

References 21 publications

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“…“Responsiveness” has recently been defined as “the ability of an instrument to detect change over time in the construct to be measured.”91 As pain is a subjective experience, this measurement requirement is difficult to document in patients with dementia and therefore merits particular attention during development of pain assessment tools. To date, as far as the authors are aware, only two studies have investigated the responsiveness of pain assessment instruments for patients with dementia and nonverbally communicating elderly people 92,93. Cohen-Mansfield and Jensen compared the responsiveness of 12 self-report, informant rating, and observational instruments to pain treatment with non-opioids and opioids.…”

Section: Pain Management In Practicementioning

confidence: 99%

Pain management in patients with dementia

Achterberg¹,

Pieper²,

Dalen-Kok³

et al. 2013

CIA

304

253

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There are an estimated 35 million people with dementia across the world, of whom 50% experience regular pain. Despite this, current assessment and treatment of pain in this patient group are inadequate. In addition to the discomfort and distress caused by pain, it is frequently the underlying cause of behavioral symptoms, which can lead to inappropriate treatment with antipsychotic medications. Pain also contributes to further complications in treatment and care. This review explores four key perspectives of pain management in dementia and makes recommendations for practice and research. The first perspective discussed is the considerable uncertainty within the literature on the impact of dementia neuropathology on pain perception and processing in Alzheimer’s disease and other dementias, where white matter lesions and brain atrophy appear to influence the neurobiology of pain. The second perspective considers the assessment of pain in dementia. This is challenging, particularly because of the limited capacity of self-report by these individuals, which means that assessment relies in large part on observational methods. A number of tools are available but the psychometric quality and clinical utility of these are uncertain. The evidence for efficient treatment (the third perspective) with analgesics is also limited, with few statistically well-powered trials. The most promising evidence supports the use of stepped treatment approaches, and indicates the benefit of pain and behavioral interventions on both these important symptoms. The fourth perspective debates further difficulties in pain management due to the lack of sufficient training and education for health care professionals at all levels, where evidence-based guidance is urgently needed. To address the current inadequate management of pain in dementia, a comprehensive approach is needed. This would include an accurate, validated assessment tool that is sensitive to different types of pain and therapeutic effects, supported by better training and support for care staff across all settings.

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Section: Pain Management In Practicementioning

confidence: 99%

Pain management in patients with dementia

Achterberg¹,

Pieper²,

Dalen-Kok³

et al. 2013

CIA

304

253

View full text Add to dashboard Cite

show abstract

“…The use of self-reported measures of pain (such as the visual analogue scale) is often problematic for older adults with severe cognitive impairment. Observational measures of pain have been developed to address this concern such as PACSLAC-F (Pain Assessment Checklist for Seniors with Limited Ability to Communicate) [2] or Elderly Pain Caring Assessment (EPCA) [17].…”

Section: Theoretical Backgroundmentioning

confidence: 99%

Acceptance and Organizational Aspects of Oral Tele-Consultation: A French Study

Petcu

Ologeanu-Taddeï

Bourdon

et al. 2016

2016 49th Hawaii International Conference on System Sciences (HICSS)

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This is a descriptive article focusing on the e-DENT project, the first oral tele-consultation in France; an experimentation of asynchronous dental tele-consultations meant to improve access to dental care for people who have limited access to regular consultations with a dentist such as dependent elderly, disabled people or prisoners. We consider that the generalization of dental tele-consultations is related to the acceptance of the e-DENT system, as stated by Broens & et al. (2007). This paper proposes a new methodological approach for assessing the perception of a medical procedure, involving the use of technology, for subjects with minor, mild or severe cognitive impairment. Semi-structured interviews, indirect patient observations and non-participant observations have allowed us to highlight the nurses' acceptance of the e-DENT system, the patients' perception of the oral tele-consultation procedure and to describe the induced organizational changes.

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“…Three scales on symptom assessment were provided one time respectively: (1) an instrument for pain assessment in elderly patients with dementia validated originally in French (36) and then validated in German (37) (Beobachtungsinstrument für das Schmerzassessment bei alten Menschen mit Demenz (BISAD)); (2) a verbal rating scale from 0 (no) to 3 (severe) for nausea, vomiting, dyspnea, anxiety, sadness, agitation, and disorientation; and (3) a numerical rating scale from 1 to 10 for pain in rest or movement pain.…”

Section: Set 2: Scales On Symptom Assessmentmentioning

confidence: 99%