Traducción al castellano y validación de la escala Abbey para la detección del dolor en pacientes no comunicativos

Abstract

Objective: The validation of a pain assessment scale for non communicative Spanish patients: Spanish version of the Abbey scale.Patients and methods: Geriatric unit in the hospital setting included all non-communicative patients over 60 years, with the exclusion of those who had respiratory failure, cerebral coma, severe brain trauma, or taking palliative oncological treatment. Variables: age, sex, carer, reason for admission, diagnosis, treatment, scale scores. Patients were evaluated using the Abbey scale for the detection of pain, Mini-Mental for evaluation of cognitive impairment, and the Global Deterioration Scale. When pain was detected it was treated with round the clock analgesics, and the patient was evaluated at 24 hour intervals, until pain was controlled, scale scores were noted each time.Statistical Analyses: Descriptive study of the variables tested. Psychometric properties: Reliability: Intrarater (ICC-intraclass correlation coefficient), Inter-rater (Kappa) and the internal consistency of the scale was measured using α-Cronbach. Validity: predictive validity was measured using ROC curve analysis, concurrent validity (Spearman) and sensitivity to change (Wilcoxon).Results: Data was collected from 119 non communicative patients; 71 (59.7%) women, mean age 81.62 ± 0.716. Pain was detected in 44 patients (37.8%). Reliability: ICC (intrarater) = 0.77; kappa (inter-rater) = 0.65 and α-cronbach RESUMENObjetivo: El dolor en pacientes no comunicativos es un problema clínico a resolver. En nuestro país, no disponemos de momento, de un método validado al castellano para paliar el problema, por lo que nos propusimos hacerlo validando la escala Abbey.Pacientes y métodos: Incluimos a aquellos pacientes mayores de 60 años, no comunicativos, de ambos sexos, y excluimos a aquellos con un estado febril o con diagnóstico de cáncer, traumatismo cráneo-encefálico, coma neurológico y a todo paciente que podía responder verbalmente a la pregunta de si "tiene usted dolor", que ingresaron a lo largo de un año en la unidad geriátrica de un hospital general. Al ingreso se aplicaron el MiniMental, la escala Reisburg (Global Deterioration Scale) y la versión española de la escala Abbey, a cada paciente que cumplía los criterios de inclusión. En aquellos pacientes con un dolor potencial, se hizo un seguimiento cada 24 h tras aplicar analgésicos con pauta horaria, según la escalera analgésica de la OMS, hasta la remisión del dolor.Tratamiento estadístico: Propiedades psicométricos de fiabilidad; alfa-cronbach, concordancia interobservador (I:Kappa) e intraobservador (ICC). Propiedades psicométricos de validez; validez predictiva para un punto de corte de tres (curva ROC, especificidad y sensibilidad, I.Youden); validez concordante en-

Instruments for pain assessment in patients with advanced dementia: A systematic review of the evidence for Latin America

“…Among the characteristics of the studies included in the systematic review, the scale most utilized was PAINAD, which was included in five studies in its Spanish (Spain) and Portuguese (Brazil) versions (Batalha et al, 2012; De La Rica Escuín and González Vaca, 2014; Gallego Valera et al, 2014; García-Soler et al, 2014; Pinto et al, 2015). The Abbey scale was only used in Spain (Chamorro and Puche, 2013), while the PACSLAC and McGill scales were used only in Brazil (De Souza Rolim et al, 2014a, 2014b; Bezerra Thé et al, 2016). Some validation studies used an analogous scale, fulfilling the function of the silver standard for pain assessment; as there is no gold standard for pain diagnosis in persons who lack the ability to communicate their pain, such as in cases of dementia (De Souza Rolim et al, 2014b; García-Soler et al, 2014; Santos and Castanho, 2014; Bezerra Thé et al, 2016).…”

“…The studies that presented the most important samples were Chamorro and Puche (2013), with a sample of 119 patients older than 60 years of age with a diagnosis of Alzheimer's and vascular dementia in a hospital geriatric unit, and Santos and Castanho (2014) with a sample of 121 patients from Portugal diagnosed with Alzheimer's disease and cognitive impairment with a mean age of 68 years (Table 3).…”

“…In practical terms, with the Abbey and PACSLAC scales that have been validated in this region, the nurse can perform a multidimensional assessment of pain in an average of 15 min, and training in the use of these scales requires only a few hours, and it has been suggested that family caregivers may also apply these scales to their relatives with dementia (Franco and De Lucas, 2001; Herr et al, 2006; McAuliffe et al, 2009; Chamorro and Puche, 2013; Montoro-Lorite and Canalias-Reverter, 2015; Papiol Espinosa and Abades Porcel, 2015; Bezerra Thé et al, 2016; Tsai et al, 2018).…”

El dolor en personas con demencia moderada o severa: revisión narrativa

“…El instrumento tiene una consistencia interna satisfactoria y distingue situaciones no dolorosas de situaciones dolorosas. Fue validada en español en el año 2013 con buenos resultados 17,18,20 .…”

Translation, cultural adaptation and recommendations for clinical implementation of the Abbey Pain Scale to a Swedish dementia care context

“…The inter-rater reliability was tested in only a few patients and was considered modest (Abbey et al, 2004). The APS has since then been translated and tested for validity in Japan (Takai et al, 2010), Denmark (Gregersen et al, 2016), Italy (Storti, 2009) and Spain (Chamorro & Puche, 2013),…”