Pain Assessment in Impaired Cognition
A European study on the psychometric properties of PAIC: a new and universal meta-tool to measure pain in persons with dementia.
ResearchersDrs. Annelore van Dalen-Kok, elderly care physician, Stichting Florence, PhD candidate, LUMC
Prof. dr. Wilco Achterberg, professor of Elderly Care Medicine, LUMC
Dr. Margot de Waal, senior researcher, LUMC
Florence, Saffier and WoonZorgcentra Haaglanden.
Multiple countries have contributes to this study, including the Netherlands, Italy, Serbia and Spain.
Aims of the PAIC study are to determine the:
1. content validity of the Dutch version of the Pain Assessment in Impaired Cognition
2. observer agreement on the individual 36 items of the Dutch version of the PAIC in a real-life nursing home setting
3. observer agreement and factor structure of each of the 36 items of the Pain Assessment in Impaired Cognition.
Pain in persons with dementia is a serious problem. Not only it is thought to be highly prevalent, but pain also has an important impact on quality of life. Pain may result in challenging behaviour, such as agitation, aggression, and depression. Besides cognitive impairment, the neuropathological changes in dementia also hamper communicative abilities. Consequently, the ability to self-report pain is seriously challenged, which is probably the main reason for poor pain management. Use of a reliable and valid observational measurement instrument to identify and measure pain in dementia is therefore recommended. Several measurement instruments have been developed, but they often lack sufficient evidence on psychometric properties, such as reliability, face and construct validity, responsiveness, and utility.
The European COST initiative 'Pain in impaired cognition, especially dementia' aims to develop a new and internationally agreed upon observational meta-tool: Pain Assessment in Impaired Cognition (PAIC). The PAIC research version consists of 36 items which were selected from 12 existing pain observation instruments, such as the PACSLAC-II and PAINAD. The final version of the PAIC consists of 15 items: PAIC 15.
In collaboration with
EU-COST action TD1005: 'Pain in impaired cognition, especially dementia'
Members of the EU-COST action 'Pain in impaired cognition, especially dementia' received EU-funding for collaborative activities such as meetings.
This study was also supported by ZonMw (part of the Family medicine and Elderly care medicine program of the SBOH: employer of elderly care medicine/general practitioner trainees)
van Dalen-Kok AH, Achterberg WP, Rijkmans WE, et al. Pain assessment in impaired cognition: observer agreement in a long-term care setting in patients with dementia.Pain Manag 2019;9(5):461-73. doi: 10.2217/pmt-2019-0025 [published Online First: 2019/08/14]
van Dalen-Kok AH, Achterberg WP, Rijkmans WE, et al. Pain Assessment in Impaired Cognition (PAIC): content validity of the Dutch version of a new and universal tool to measure pain in dementia.Clin Interv Aging 2018;13:25-34. doi: 10.2147/CIA.S144651
de Waal MWM, van Dalen-Kok AH, de Vet HCW, et al. Observational pain assessment in older persons with dementia in four countries: Observer agreement of items and factor structure of the Pain Assessment in Impaire Cognition.Eur J Pain 2020;24(2):279-96. doi: 10.1002/ejp.1484 [published Online First: 2019/09/15]
Kunz M, de Waal MWM, Achterberg WP, et al. The Pain Assessment in Impaired Cognition scale (PAIC15): A multidisciplinary and international approach to develop and test a meta-tool for pain assessment in impaired cognition, especially dementia.Eur J Pain 2020;24(1):192-208. doi: 10.1002/ejp.1477 [published Online First: 2019/09/06]