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Pain assessment in impaired cognition: observer agreement in a long-term care setting in patients with dementia
Annelore H van Dalen-Kok1,2, Wilco P Achterberg1, Wieke E Rijkmans1
1Department of Public Health & Primary Care, Leiden University Medical Center, Hippocratespad 21 Postal zone V0-P, PO Box 9600, 2300 RC Leiden, The Netherlands.
Abstract:
Aim: To study the application of the meta-tool Pain Assessment in Impaired Cognition (PAIC) in a clinical setting in patients with moderate to severe dementia. Materials & methods: Observational study in five Dutch nursing homes, where residents were observed by nurses or nurse-assistants during rest and movement. Prevalence and observer agreement of individual items were examined. Results: An observer agreement of ≥70% was found for most items of the body movement domain and vocalization domain, although prevalence of these behaviors was low (especially during rest). Items of the facial expression domain had a percentage agreement <70%, especially during movement, but with high prevalence of behaviors. Conclusion: The pain assessment in impaired cognition items show promising interobserver and intraobserver agreement in a clinical setting.
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