Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools

BMC Geriatrics

Research Article

Dawn Dowding¹  Michelle Briggs²  S José Closs³  Philip Esterhuizen³  Valentina Lichtner³  Andrew F Long³  Anne Corbett⁴ 

[1] Columbia University School of Nursing, 617 West 168th Street, 10032, New York, NY, USA;Center for Home Care Policy and Research, Visiting Nurse Service of New York, 5 Penn Plaza, 10001, New York, NY, USA;Institute of Health and Wellbeing, Leeds Beckett University, Leeds, UK;School of Healthcare, University of Leeds, Leeds, UK;Wolfson Centre for Age-Related Diseases, King’s College London, SE1 1UL, London, UK;

关键词: Pain assessment;    Pain scales;    Aged;    Dementia;    Meta-review;   

DOI  :  10.1186/1471-2318-14-138

 received in 2014-07-29, accepted in 2014-12-11,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThere is evidence of under-detection and poor management of pain in patients with dementia, in both long-term and acute care. Accurate assessment of pain in people with dementia is challenging and pain assessment tools have received considerable attention over the years, with an increasing number of tools made available. Systematic reviews on the evidence of their validity and utility mostly compare different sets of tools. This review of systematic reviews analyses and summarises evidence concerning the psychometric properties and clinical utility of pain assessment tools in adults with dementia or cognitive impairment.MethodsWe searched for systematic reviews of pain assessment tools providing evidence of reliability, validity and clinical utility. Two reviewers independently assessed each review and extracted data from them, with a third reviewer mediating when consensus was not reached. Analysis of the data was carried out collaboratively. The reviews were synthesised using a narrative synthesis approach.ResultsWe retrieved 441 potentially eligible reviews, 23 met the criteria for inclusion and 8 provided data for extraction. Each review evaluated between 8 and 13 tools, in aggregate providing evidence on a total of 28 tools. The quality of the reviews varied and the reporting often lacked sufficient methodological detail for quality assessment. The 28 tools appear to have been studied in a variety of settings and with varied types of patients. The reviews identified several methodological limitations across the original studies. The lack of a ‘gold standard’ significantly hinders the evaluation of tools’ validity. Most importantly, the samples were small providing limited evidence for use of any of the tools across settings or populations.ConclusionsThere are a considerable number of pain assessment tools available for use with the elderly cognitive impaired population. However there is limited evidence about their reliability, validity and clinical utility. On the basis of this review no one tool can be recommended given the existing evidence.

【 授权许可】

CC BY   
© Lichtner et al.; licensee BioMed Central. 2014