Full
Outline
To compare the psychometric properties,feasibility,and clinical utility of the Pain Intensity Measure for Persons with Dementia(PIMD) and the Mobilization-Observation-Behaviour-Intensity-Dementia Pain Scale(MOBID-2) for pain assessment in hospitalized older adults with cognitive impairment.
A total of 134 hospitalized older adults with cognitive impairment from a tertiary grade A hospital in Guangdong province were enrolled.Using the Chinese version of the Pain Assessment in Advanced Dementia Scale(PAINAD) as the criterion,patient's self-reported Numeric Rating Scale pain scores were obtained,followed by pain assessments at rest and during activity using the three scales(PAINAD,PIMD,and MOBID-2) in random order.The internal consistency,inter-rater reliability,criterion validity,construct validity,and pain screening ability were compared between PIMD and MOBID-2.Additionally,22 clinical nurses from six hospitals in Guangdong Province evaluated the feasibility and clinical utility of the two scales.
At rest and during activity,the Cronbach's alpha coefficients of PIMD were 0.821 and 0.889,and the inter-rater reliability coefficients were 0.847 and 0.839,respectively.Exploratory factor analysis extracted two common factors for the PIMD in both states,with cumulative variance contribution rates of 71.047% and 77.402%,respectively.Regarding criterion validity,the correlation coefficients between the PIMD and the PAINAD were 0.996 at rest and 0.954 during activity.During activity,the Cronbach's alpha coefficient of the MOBID-2 was 0.781,and the inter-rater reliability coefficient was 0.775;exploratory factor analysis extracted four common factors with a cumulative variance contribution rate of 67.229%;the correlation coefficient between the MOBID-2 and the PAINAD was 0.883.The area under the receiver operating characteristic curve(AUC) for the PIMD and the MOBID-2 were 0.984 and 0.930,with sensitivities of 91.9% and 71.2%,and specificities of 95.7% and 100.0%,respectively.The Kappa values for agreement among the three scales were all>0.4,and the pain detection rates ranged from 59.0% to 82.8%.The mean feasibility and utility scores for the PIMD and the MOBID-2 were 4.2 and 4.2,3.7 and 4.2,respectively.
The PIMD demonstrates good reliability and validity,while MOBID-2 shows good reliability but moderate validity.Both scales can be used for pain assessment in hospitalized older adults with cognitive impairment.However,considering the psychometric properties,feasibility,and clinical utility of each scale,PIMD is recommended as the priority choice.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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