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Acta Anaesthesiol Scand. 2009 May;53(5):657-64. doi: 10.1111/j.1399-6576.2009.01942.x.

Evaluation of easily applicable pain measurement tools for the assessment of pain in demented patients.

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  • 1Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland. anne.pesonen@hus.fi

Abstract

BACKGROUND AND OBJECTIVES:

Difficulties in communication and lack of suitable pain scales may lead to undertreatment of pain in cognitively impaired patients. We performed a study in this type of patients and evaluated the usefulness of four simple pain scales.

PATIENTS AND METHODS:

We studied 41 hospitalized elderly (76-95 years) who suffered from pain with an acute component. Cognitive function was assessed with the mini-mental state examination (MMSE) and the degree of depression was assessed on the geriatric depression scale (GDS). Pain intensity was assessed at rest and after a pain-provoking movement three times at 2-week intervals by repeating the test at a 10-min interval at each test session. The pain scales were the 50 cm red wedge scale (RWS), the seven-point faces pain scale (FPS), the 10 cm visual analogue scale (VAS) and the five-point verbal rating scale (VRS).

RESULTS:

In group MMSE> or =24, patients were able to use all four scales rather successfully. In the other groups (MMSE 17-23, 11-16 and < or =10), only the use of VRS was successful to a reasonable degree (64-85% on average). GDS scores did not correlate with the pain scores, with the exception of pain scores on FPS during movement (P<0.01). The estimations of intensity and frequency of pain performed by nurses failed to correlate with the patient's own pain intensity estimations.

CONCLUSION:

Scoring of pain with RWS, FPS and VAS seems to be feasible in elderly patients with a normal cognitive dysfunction. In our study VRS appeared to be applicable in the elderly with a clear cognitive dysfunction, i.e., with MMSE<17.

PMID:
19419361
[PubMed - indexed for MEDLINE]
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