[A comparison study between two pain assessment scales for hospitalized and cognitively impaired patients with...

The management of pain in a elderly patients with advanced dementia is a very frequently problem in geriatric wards. The pain in patients with advanced dementia whose verbal fluency is declining is underestimated and poorly treated and this is mainly due to the lack of availability of proper tools able to recognise and to assess this disease symptom in those patients. During recent years major progress has taken place, and valid scales that allow for the assessment of the pain also in those kind of patients have been developed. The objective of this research is to verify the pertinence of the PAINAD and ABBEY scales throughout the assessment of pain in a 30 resident patients in care of a geriatric setting. The thirty elderly were average age 86 years (18 female and 12 male) with vascular dementia or late stage Alzheimer's disease, completely dependant on ADLs and with global aphasia. After 48 hours from the acceptance to hospital the pain has been identified. The pain assessment was carried out by administering the PAINAD (already validate in italian) and ABBEY scales by the nurse responsible for the patient and by a second nurse, for an amount of four surveys for each patients. Results show that both scales give equivalent results for the pain assessment (K=0.68), with concordance asset moderately good between the exams taken by the two nurses (Cohen K rate between 0.49 and 0.58). The PAINAD scale requires an administering time far lower than the ABBEY scale (p 0.001) and both can be used for the assessment of pain in those patients, also in the hospital.