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Validation of an acute pain‐behavior scale for older persons with inability to communicate verbally: Algoplus®
Author(s) -
Ratl Patrice,
Jouvel Elisabeth,
Pickeringl Gisèle,
Donnarell Laurent,
Nguyenl Louise,
Michell Micheline,
CaprizRibièrel Françoise,
LefebvreChapirol Sylvie,
Gauquelinl Frédérique,
BoninGuillaumel Sylvie
Publication year - 2011
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1016/j.ejpain.2010.06.012
Subject(s) - rating scale , acute pain , inter rater reliability , pain scale , physical therapy , acute care , psychology , pain assessment , intraclass correlation , visual analogue scale , discriminant validity , scale (ratio) , medicine , internal consistency , pain management , psychometrics , clinical psychology , anesthesia , developmental psychology , health care , physics , quantum mechanics , economic growth , economics
To compensate for poor acute pain detection in elderly inpatients with inability to communicate verbally (ICV), the Doloplus Collective team devised the 5‐item Algoplus® behavior‐assessment scale specifically aimed at quickly detecting acute pain in these individuals. Algoplus® was developed in three successive phases, including expert opinions, caregivers interviews, patient video recordings and statistical procedures. Among the 1500 recorded primary pain behaviors, 48 were selected and clustered into a 5‐item scale. This version was validated based on 349 old inpatients (204 with acute pain and 145 without) from different care settings and hospitals. Comparators were objective acute pain clinical situations, experts' clinical judgment on acute pain presence, and self‐rating scales (Visual Analog Scale, Numeric Rating Scale and Verbal Descriptor Scale) for a communicative subsample (n =134). Algoplus® showed good discriminant validity with adequate internal consistency (Kuder—Richardson‐20, 0.712), excellent interrater reliability (intraclass coefficient, 0.812) and high sensitivity to change during specific pain situations and after starting pain management. Excellent correlations were observed between Algoplus® and experts' clinical judgment, acute pain clinical situations or each comparator self‐rating—pain score. For patients with acute pain conditions, a score ≥2 out of 5 on the Algoplus® scale was retained as the threshold for the presence of acute pain in elderly ICV inpatients, with 87% sensitivity and 80% specificity. In addition, the very brief rating time of ∼1 min is particularly relevant in acute‐care settings, where repetitive pain‐monitoring is required.