Assessment tool/source | Dimensions/items Scoring range | Origin of items | Number of participants/CI participants | Validity | Homogeneity IC | Reliability | Feasibility | Overall judgement (range 0–20) | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
 |  |  |  | Content | Criterion | Construct I relation other pain tools | Construct II differentiates |  | Inter-rater | Intra-rater or Test-retest |  |  |
DOLOPLUS 2 Wary et al., (1992 first version, France) | 10 items, 3 dimensions somatic (N = 5 items) psychomotor (N = 2) psycho-social (N = 3) scoring range 0–30 | modified pain scale for children (DEGR) | N = 510 N> 100 CI (few non-communicative) | y | ? | Y VAS-DOLOPLUS r very significant | y ? differs in time | y alpha .82 | y kappa = ?? | y test-retest | incl. instructions, lexicon scoring interpretation English version available |  |
 |  | 1 | 2 | 1 | 0 | 1 | 1 | 2 | 1 | 1 | 1 | 11 |
L'Echelle Comportementale pour Personne Agées (ECPA) Alix et al . (1993, France) | 11 items, 3 dimensions pre-care post-care during activities scoring range 0–44 | modified pain scale for children (DEGR) | N = 118 N = ?? CI | y | n | y VAS-EPCA Pearson r = .67 (N = 16) | ? differs in time factor analysis | y alpha .70 | y Intra Class r = .80 | ? | manageable scale scoring interpretation not available German version available |  |
 |  | 1 | 1 | 1 | 0 | 2 | 1 | 2 | 2 | 0 | 1 | 11 |
L'échelle Comportementale simplifiée (l'ECS) Baulon et al. (1995, France) | 10 items scoring range 0–14 | newly developed, (multidisc. opinion) not specific for CI | N = 146 N = ?? CI | ? | n | n | ? | ? | ? | ? | incl. instructions, lexicon |  |
 |  | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 4 |
The Observational Behavior Tool Simons & Malabar (1995, UK) | 25 items, 7 dimensions verbal response (N = 8) facial expression (N = 3) body language (N = 5) conscious state (N = 3) physiological change (N = 3) behavioural change (N = 1) feedback from others (N = 2) scoring range 0–25 | items derived from chronic back pain tool | N = 105 39 of 105 non-verbal | y | n | n | n | n | n | n | ? manageable scale scoring interpretation not available |  |
 |  | 0 | 2 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 4 |
Checklist of Non-Verbal Pain Indicators (CNPI) Feldt et al. (2000, USA) | 6 clustered items (rest vs. movement) scoring range 0–6 | modified pain scale | N = 88 elderly hip fracture patients 53 CI, 35 NI | y | n | y r VDS/CNPI r = .372 at rest r = .428 movement | y CNPI rest vs movement pre- vs post-operative | y Low, alpha .54–.64 | y 93% dichotomous Kappa .63–.82 (N = 12) | n | y short, incl. instructions, scoring interpretation |  |
 |  | 1 | 1 | 1 | 0 | 0 | 1 | 0 | 1 | 0 | 2 | 7 |
Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) Hadjistavropoulos et al. (2002, Canada) | 60 items, 4 dimensions facial expressions (N = 13) activity/body movements (N = 20) social/personality/mood (N = 12) physiological/eating/sleeping/vocal (N = 15) scoring range 0–60 | newly developed for this group of elderly | Study 1 N = 28 nurses Study 2 N = 40 nurses Study 3 N = 40 nurses | y | n | y 0–10 scale/PACSLAC r = .39–.54 | y differentiates pain and calm event r = .8 between pain scenes | y moderate-good . 82–.87 total scale . 55–.73 subscales in study 3 | n | n (only for transcript interviews .94) | y long but simple list |  |
 |  | 2 | 2 | 2 | 0 | 1 | 1 | 2 | 0 | 0 | 1 | 11 |
Pain Assessment in Advanced Dementia (PAINAD) Warden, Hurley and Volicer. (2002, USA) | 5 (categorical) items breathing negative vocalization facial expression body language consolability scoring range 0–10 | modified pain scale | N = 19 observed CI N = 25 records | y | n | y VAS/PAINAID Pearson r = .75– .76 DS-DAT/PAINAID Pearson r = .76 | y factor analysis differentiates between pleasant and aversive pre/post-medication | y moderate < .70 | y Pearson r = .82–.97 | n | y categorical but short, manageable scale item explanation incl. |  |
 |  | 1 | 0 | 1 | 0 | 2 | 2 | 1 | 2 | 0 | 2 | 11 |
Pain Assessment in Dementing Elderly (PADE) Villanueva et al. (2003, USA) | 24 items, 3 parts physically observable facial expressions global pain assessment functional activities | newly developed for this group of elderly (literature, interviews, observations) | Study 1 N = 25 CI Study 2 N = 40 CI | y | n | ? | y differentiates between pain and no pain CMAI (agitation)/PADE r = .3–.4 | y alpha= 0.24–0.88 part 1 good part 3 low | y Intra Class r study 1 .81–.96 study 2 .54–.96 | y test-retest Intra Class r study 1 .34–.89 study 2 .70–.98 (part 2 lowest) | ? difficult format due to different scaling (Likert, VAS, Multiple choice), long list |  |
 |  | 2 | 1 | 2 | 0 | 0 | 1 | 1 | 2 | 1 | 0 | 10 |
Rating Pain in Dementia (RaPID) Sign & Orrell. (2003, UK) | 18 (clustered) items, 4 dimensions behavioural (N = 11) emotional (N = 2) autonomic (N = 2) postural (N = 3) scoring range 0–54 | newly developed for this group of elderly (literature, experts) | N = 48 demented | y | n | y RaPID/McGill/VAS scores r = .8–.86 | n | y .79 total scale | y mean .97 based on interviews with caregiver- pat. | y test-retest >.75 for all items based on interviews with caregiver- pat. | y clustered but list of acceptable length scoring interpretation not available |  |
 |  | 1 | 1 | 2 | 0 | 2 | 0 | 2 | 0 | 0 | 1 | 9 |
The Abbey Pain Scale Abbey et al. (2004, Australia) | 6 (categorical) items vocalisation facial expression change in body language behavioural change physiological change physical change scoring range 0–18 | modified pain scale (items derived from Hurley (1992) and Simons & Malabar (1995) Modified by experts trough a Delphi study | Stage 1 N = 52 CI (770 pain episodes) Stage 2 N = 61 CI (236 pain episodes) | y | n | y nurses holistic assessment/Abbey scale r = .59 | y differentiates between pre and post intervention | y .74–.81 total scale | y low-modest coefficient = ?? | n | y categorical but short, manageable scale |  |
 |  | 1 | 2 | 1 | 0 | 1 | 1 | 2 | 0 | 0 | 2 | 10 |
The Non-Communicative Patient's Pain Assessment Instrument (NOPPAIN) Snow et al. (2004, USA) | 4 sections/parts e.g. observed daily activities pain response (6 items: words, pain faces, noises, bracing, rubbing, restlessness on a 6 point Likert scale) pain location pain thermometer | (multidisc. expert opinion) No specific information about origin of the items | N = 37 CI in a initial feasibility study N = 21 NA (6 video's) | y | n | y video gold standard/NA ratings kappa = .87 low intensity pain condition had smallest parameters | n | n | n | n | y brief, not time consuming scoring interpretation not available | Â |
 |  | 1 | 0 | 1 | 0 | 2 | 0 | 0 | 0 | 0 | 1 | 5 |
Pain Assessment Tool for Use with Cognitive Impaired Adults Davies et al. (2004, Australia) | 11 sections/parts e.g. existing painful conditions physiological measures self-report of pain facial expression usual behaviours changes in behaviours (5 headings: vocalisation, body posture, activities of daily living, cognitive functioning, physical changes) usual and new comfort measures | newly developed for this group of elderly (literature, experts, focus group discussion) | N = 27 CI N = 14 nurses | y | n | n | n | n | n | n | y difficult format due to different scaling (e.g. body map, physiological and behavioural items), long list, time consuming | Â |
 |  | 2 | 0 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4 |