Use of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate-II (Pacslac-II) by People Who Are Not Health Professionals

Date
2016-07-07
Authors
Ammaturo, Delaine Ariele
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Faculty of Graduate Studies and Research, University of Regina
Abstract

Pain is prevalent among older adults but it is often underestimated and undertreated, especially in older people with dementia. Patients with severe dementia are likely to suffer from untreated pain because of their limited ability to report it. Observational methods of pain assessment, such as the Pain Assessment Checklist for Seniors with Limited Ability to Communicate-II (PACSLAC-II; Chan, Hadjistavropoulos, Williams, & Lints-Martindale, 2014), have been shown to be valid indicators of pain in this population when completed by health professionals or other trained personnel (Fuchs-Lacelle, Hadjistavropoulos, & Lix, 2008; Zwakhalen, Hamers, Abu-Saad, & Berger, 2006). With growing demands, informal caregivers who are laypersons are an untapped assessor group, although they often have the primary responsibility for seniors with dementia. The goal of this investigation was to compare the behavioural pain assessment ability of persons who are not health professionals to that of experienced nursing staff. Videos depicting dementia patients expressing pain were presented to professional and non-professional participants. Both groups (i.e., laypersons and long-term care staff) were shown the video segments in random order and then completed the PACSLAC-II, the Pain Assessment in Advanced Dementia Scale (PAINAD; Warden, Hurley, & Volicer, 2003) as an index of concurrent validity, and a Global Rating Scale for each video segment. The responses of the two groups were compared. As expected, both laypeople and nurses were able to effectively differentiate painful from non-painful situations. Both groups were also able to discriminate between gradations of pain (i.e., baseline, mild, moderate, severe). Moreover, tool internal consistency was compared as a function of professional and non-professional status. Results confirmed the validity and reliability among non-professional adults when using the PACSLAC-II and the PAINAD to assess pain. Exploratory analyses did not identify a systematic relationship between demographic characteristics of participants and pain ratings provided. It was concluded that, as hypothesized, both instruments can be used for the assessment of pain in patients with dementia by laypeople. This study is the first to validate these instruments for use by laypeople. These findings will help to promote the assessment of pain in community settings, thus facilitating pain treatment and earlier detection of symptoms in older adults with dementia. Keywords: Pain; Dementia; Older Adults; Observational Pain Assessment

Description
A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Arts in Clinical Psychology, University of Regina. ix, 97 p.
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