Buket BÜYÜKTURAN, Mehmet İlkin NAHARCI, Öznur BÜYÜKTURAN, Aysu YETİŞ, Nuray KIRDI

Reliability and validity of the Turkish version of Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-T)

Background/aim: This study aimed to assess validity and reliability of the Turkish version of Pain Assessment Checklist for Seniors withLimited Ability to Communicate (PACSLAC-T).Materials and methods: The individuals who met inclusion criteria of the study were in patients of a hospital and a long-term carefacility. Mini Mental Status Exam (MMSE), Cornell Dementia Depression Scale (CDDS), Global Deterioration Scale (GDS), visualanalogue scale (VAS), and PACSLAC-T were administered to all subjects. The scales were repeated with an interval of two weeks fortest–retest reliability.Results: A total of 112 patients with dementia were included in the study. The intraclass correlation coefficient ICC for test–retestreliability of the PACSLAC-T was 0.713 with a 95% confidence interval of 0.486–0.843. The Cronbach’s α coefficient for total PACSLAC-Twas 0.842 for test and 0.888 for retest, which indicated substantial internal consistency. In convergent validity, there were significantcorrelations between PACSLAC-T total score VAS (r = 0.684, P < 0.001), while no correlation was found between PACSLAC-T totalscore and CDDS (r = 0.127, P = 0.094), and GDS (r = 0.096, P = 0.167). Also, significant correlations were found between PACSLAC-Ttotal score and MMSE (r = –0.468, P = 0.016).Conclusion: This study showed that PACSLAC-T could be a promising tool for the management of pain in older adults with limitedcommunication skills.

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Molony SL, Kobayashi M, Holleran EA, Mezey M. Assessing pain as a fifth vital sign in long-term care facilities: Recommendations from the field. J Gerontol Nurs 2005; 31: 16-24.
Herr K. Pain assessment strategies in older patients. J Pain 2011; 12: 3-13.
Huffman JC, Kunik ME. Assessment and understanding of pain in patients with dementia. Gerontologist 2000; 40: 574- 581.
Marzinski LR. The tragedy of dementia: Clinically assessing pain in the confused, nonverbal elderly. J Gerontol Nurs 1991; 17: 25-28.
Coker E, Papaioannou A, Kaasalainen S, Dolovich L, Turpie I, Taniguchi A. Nurses’ perceived barriers to optimal pain management in older adults on acute medical units. Appl Nurs Res 2010; 23: 139-146.
Takai Y, Yamamoto-Mitani N, Suzuki M, Furuta Y, Sato A, Fujimaki Y. Developing and validating a Japanese version of the Assessment of Pain in Elderly People with Communication Impairment. Arch Gerontol Geriatr 2013; 57: 403-410.
Persons O. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc 2009; 57: 1331-1346.
Hurley AC, Volicer BJ, Hanrahan PA, Houde S, Volicer L. Assessment of discomfort in advanced Alzheimer patients. Res Nurs Health 1992; 15: 369-377.
Feldt KS. The checklist of nonverbal pain indicators (CNPI). Pain Manag Nurs 2000; 1: 13-21.
Lefebvre-Chapiro S. The Doloplus-2 scale: evaluating pain in the elderly. Eur J Palliat Care 2001; 8: 191-194.
Villanueva MR, Smith TL, Erickson JS, Lee AC, Singer CM. Pain assessment for the dementing elderly (PADE): reliability and validity of a new measure. J Am Med Dir Assoc 2003; 4: 1-8.
Abbey J, Piller N, De Bellis A, Esterman A, Parker D, Giles L, Lowcay B. The Abbey pain scale: a 1-minute numerical indicator for people with end-stage dementia. Int J Palliat Nurs 2004; 10: 6-13.
Snow AL, Weber JB, O’Malley KJ, Cody M, Beck C, Bruera E, Ashton C, Kunik ME. NOPPAIN: a nursing assistantadministered pain assessment instrument for use in dementia. Dement Geriatr Cogn Disord 2004; 17: 240-246.
Warden V, Hurley AC, Volicer L. Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) scale. J Am Med Dir Assoc 2003; 4: 9-15.
Fuchs-Lacelle S, Hadjistavropoulos T. Development and preliminary validation of the pain assessment checklist for seniors with limited ability to communicate (PACSLAC). Pain Manag Nurs 2004; 5: 37-49.
Hadjistavropoulos T, Hunter P, Dever Fitzgerald T. Pain assessment and management in older adults: Conceptual issues and clinical challenges. Can Psychol 2009; 50: 241-254.
Lucas KH, Terpening CM, Elliott DP. Regarding the management of persistent pain in older persons. J Am Geriatr Soc 2003; 51: 1045.
Lints-Martindale AC, Hadjistavropoulos T, Lix LM, Thorpe L. A comparative investigation of observational pain assessment tools for older adults with dementia. Clin J Pain. 2012; 28: 226- 237.
Zwakhalen SM, Hamers JP, Berger MP. The psychometric quality and clinical usefulness of three pain assessment tools for elderly people with dementia. Pain. 2006; 126: 210-220.
Aubin M, Giguère A, Hadjistavropoulos T, Verreault R. The systematic evaluation of instruments designed to assess pain in persons with limited ability to communicate. Pain Res Manag 2007; 12: 195-203.
Zwakhalen S, Hamers JP, Abu-Saad HH, Berger M. Pain in elderly people with severe dementia: a systematic review of behavioural pain assessment tools. BMC Geriatr. 2006; 6: 3.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). 5th ed. Washington, USA: APA Publishing; 2013.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-198.
Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Standardize mini mental test’in Türk toplumunda hafif demans tanısında geçerlik ve güvenilirliği. Turk Psikiyatri Derg 2002; 13: 273- 281.
Alexopoulos GS, Abrams RC, Young RC, Shamoian CA. Cornell scale for depression in dementia. Biol Psychiat 1988; 23: 271-284.
Amuk T, Karadağ F, Oğuzhanoğlu N, Oğuzhanoğlu A. Reliability and validity of the Cornell Scale for Depression in Dementia in an elderly Turkish population. Turk Psikiyatri Derg 2003; 14: 263-271.
Reisberg B, Ferris SH, de Leon MJ, Crook T. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry 1982; 139: 1136-1139.
Cheung G, Choi P. The use of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) by caregivers in dementia care. N Z Med J 2008; 121: 21-29.
Liu JY, Briggs M, Closs SJ. The psychometric qualities of four observational pain tools (OPTs) for the assessment of pain in elderly people with osteoarthritic pain. J Pain Symptom Manage 2010; 40: 582-598.
Zwakhalen SM, Koopmans RT, Geels PJ, Berger MP, Hamers JP. The prevalence of pain in nursing home residents with dementia measured using an observational pain scale. Eur J Pain 2009; 13: 89-93.
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 2000; 25: 3186-3191.
Deyo RA, Diehr P, Patrick DL. Reproducibility and responsiveness of health status measures statistics and strategies for evaluation. Control Clin Trials 1991; 12: 142-158.
Gazoni FM, Cherpak GL, Lorenzet IC, Santos LAd, Nardes EM, Santos FCd. Pain assessment in elderly with dementia: Brazilian validation of the PACSLAC scale. Einstein (Sao Paulo) 2016; 14: 152-157.
Kim EK, Kim SY, Eom MR, Kim HS, Lee E. Validity and reliability of the Korean version of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate. J Korean Acad Nurs 2014; 44: 398-406.
Shega JW, Rudy T, Keefe FJ, Perri LC, Mengin OT, Weiner DK. Validity of pain behaviors in persons with mild to moderate cognitive impairment. J Am Geriatr Soc 2008; 56: 1631-1637.