scholarly journals MP42: Validation of the Stoplight Pain Scale tool in the Canadian emergency setting

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S55-S56
Author(s):  
S. Shwetz ◽  
E. Morrison ◽  
A. Drendel ◽  
M. Yaskina ◽  
M. Rajagopal ◽  
...  
Keyword(s):  
Family Involvement ◽  
Pain Assessment ◽  
Assessment Tool ◽  
Pain Treatment ◽  
Pain Scale ◽  
Assessment Tools ◽  
Future Research ◽  
Kappa Statistics ◽  
Emergency Setting ◽  
Direct Guidance

Introduction: Introduction: A variety of pain assessment tools exist for children, however none of the current scales were created specifically for family use. Further, none provide direct guidance with regards to pain treatment threshold. This study aimed to validate a novel, three faced, coloured coded (red, yellow, green), family-friendly pain tool, the Stoplight Pain Scale, by comparing it to the widely accepted and validated Faces Pain Scale-Revised (FPS-R). This novel tool has the capability to guide families with regards to treatment, as well as measure pain. Methods: Methods: A prospective observational cohort study was conducted at the Stollery Childrens Hospital emergency department (ED) (Edmonton, Alberta) from November, 2014 to February, 2017. Demographic information was collected, and patients (3-12 years) and their caregivers were asked to rate their pain using the novel Stoplight Pain Scale as well as the FPS-R. Pain was measured at presentation to the ED, immediately following painful procedures, and thirty minutes after analgesia administration. Patients and their caregivers also indicated their preferred scale for assessing pain. Results: Results: A purposeful random sample of 227 patients were included for analyses; 61/227 (26.9%) of patients were 3-5 years old and 166/227 (73.1%)were 6-12 years old. 53/227 (23.3%) of patients had been previously hospitalized. Correlation between the two pain scales was consistently fair to moderate; using Kappa Statistics, a baseline correlation for Stoplight and FPS-R was fair for both caregivers (0.38, 95% CI 0.28 0.48) and patients (0.36 95% CI 0.27-0.45). The Stoplight Pain Scale had fair to moderate correlation between caregiver and patient scores, (0.37, 95% CI 0.27-0.47), compared to FPS-R which showed poor to fair agreement between caregiver and child scores (0.20, 95% CI 0.12-0.29). Regardless of age or hospitalization status, 64% of patients (139/218) and 54% caregivers (118/220) preferred the Stoplight Pain scale (p=0.001). Conclusion: Conclusions: The Stoplight Pain Scale correlates moderately well with FPS-R, a validated pain assessment tool for children and shows good correlation between patients and caregivers assessment of reported pain. The Stoplight Pain Scale is a simple, easy to administer tool that may have a role in empowering family involvement in ED pain management. Future research should focus on at-home study of the tool.

Adoption of a Pain Assessment Tool in Older Homebound Patients With Dementia in a Housecall Practice: A Dissemination Study

2012 ◽  
Vol 5 (2) ◽  
pp. 124-131 ◽  
Author(s):  
Jean-Claude K. Provost
Keyword(s):  
Older Adults ◽  
Pain Assessment ◽  
Assessment Tool ◽  
Selection Process ◽  
Pain Scale ◽  
Assessment Tools ◽  
Advanced Dementia ◽  
Pain Diagnosis

This article describes the steps of a pilot dissemination study toward adopting a pain assessment tool for older homebound adults with dementia. The chosen practice site had not previously used adequate pain assessment tools for older adults with dementia. After the selection process by a pain assessment tool committee, providers (N = 20) were asked to choose between three tools: pain assessment in advanced dementia (PAINAD), the Abbey Pain Scale, and DOLOPLUS-2/ DOLOSHORT. Providers voted to use the PAINAD (54%) for the following 2 weeks. A preintervention audit showed that without the use of a pain assessment tool, 97.7% of the charts did not have any documentation of a pain diagnosis nor an intervention. Postintervention using PAINAD, 91.3% of the charts had both (χ2[1] = 18.645, p < .001). The feedback obtained from providers (n = 10) after 2 weeks of testing the tool was unanimously positive. Many providers reported increased confidence in identifying pain and some changed their practice by placing pain assessment in the forefront of their encounter with their older clients with dementia. PAINAD was adopted as the pain assessment tool for this practice.

scholarly journals Are the current pain assessment tools used by paramedics in Ireland, suitable for use with cognitively impaired (dementia) patients?

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Liam Rooney
Keyword(s):  
Pain Assessment ◽  
Rating Scale ◽  
Assessment Tool ◽  
Hospital Setting ◽  
Reliability And Validity ◽  
Pain Scale ◽  
Assessment Tools ◽  
Self Report ◽  
Good Reliability ◽  
Dementia Patients

<p><span style="text-decoration: underline;"><strong>Background</strong></span></p><p>Dementia is a disease affecting 55,000 Irish people. (1)  It is characterised by progressive cognitive impairment, ranging from mild impairment, which may affect memory, to severe impairment where the ability to communicate may be absent.  These people are at risk of having their pain underassessed and undermanaged. (2)  A survey exploring Irish Paramedics and Advanced Paramedics views on the current pain assessment tools available to them, and whether these tools are suitable for use with dementia patients is proposed.  Existing observational pain assessment tools used with dementia patients are examined and their suitability for pre-hospital use discussed.</p><p><span style="text-decoration: underline;"><strong>Introduction</strong></span></p><p>Adults with cognitive impairments, such as dementia, are at a much higher risk of not receiving adequate analgesia for their pain. (3)  It is estimated between 40% and 80% of dementia patients regularly experience pain. (4)  Current pain assessment tools used pre-hospital in Ireland are: Numerical Rating Scale for patients &gt;8yrs, Wong Baker Scale for pediatric patients and the FLACC Scale for infants.  There is no specific pain assessment tool for use with patients who are not capable of self-reporting their level of pain.</p><p><span style="text-decoration: underline;"><strong>Objective</strong></span></p><p>This research aimed to identify observational pain assessment tools used in this cohort.  The most consistently recommended tools were identified.  The suitability of these tools for use in the pre-hospital setting assessed.</p><p><span style="text-decoration: underline;"><strong>Findings</strong></span></p><p>Literature review identified 29 observational pain assessment tools. There is a lack of literature relating to the pre-hospital setting.  The American Geriatric Society (AGS) identified six pain behaviors in dementia patients, changes in facial expression, activity patterns, interpersonal relationships and mental status, negative vocalisation, change in body language.  These six criteria should be the foundation of any pain assessment tool. (5) The three most consistently recommended tools identified were as follows:</p><p><em>Abbey Pain Scale</em></p><p>6 items assessed, meets AGS criteria, quick and easy to implement, moderate to good reliability and validity (6)</p><p><em>Doloplus 2</em></p><p>15 items assessed, meets 5 of 6 AGS criteria, requires observation over time, prior knowledge of patient required, moderate to good reliability and validity (6)</p><p><em>PAINAD</em></p><p>5 items assessed, meets 3 of 6 AGS criteria, less then 5 minutes to implement, may be influenced by psychological distress, good reliability and validity (6)</p><p> </p><p><span style="text-decoration: underline;"><strong>Conclusion</strong></span></p><p>The ability to self report pain is deemed “gold standard”.  Patients with mild to moderate disease, and indeed, some with severe disease, may retain the ability to self report.  An observational tool is required when dementia has progressed to the point where the patient becomes unable to self report or becomes non-verbal.  It is in these patients where undetected, misinterpreted or inaccurate assessment of pain becomes frequent. (7)  The aim of any tool is to gain a good assessment of pain, however, the pain scale used should be suitable to the clinical setting.  The feasibility of an assessment tool is an important factor along with reliability and validity.  No one assessment tool could be recommended over another.  Abbey and PAINAD have potential for use pre-hospital, however, further research, clinical evaluation and trial in an ambulance service is required.</p>

scholarly journals Pain-measurement tools in sickle cell disease: where are we now?

Hematology ◽  
2017 ◽  
Vol 2017 (1) ◽  
pp. 534-541 ◽  
Author(s):  
Deepika S. Darbari ◽  
Amanda M. Brandow
Keyword(s):  
Chronic Pain ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Pain Assessment ◽  
Assessment Tool ◽  
Pain Treatment ◽  
Underlying Mechanism ◽  
Assessment Tools ◽  
Cell Disease ◽  
Pain Mechanisms

AbstractPain is a complex multidimensional experience and the most common morbidity in patients with sickle cell disease (SCD). Tools to assess pain can be of use not only to guide pain treatment but also to provide insight into underlying pain neurobiology. Mechanisms of pain in SCD are multifactorial and are not completely elucidated. Although vaso-occlusion of microcirculation by sickled red cells is believed to be the underlying mechanism of acute vaso-occlusive pain, mechanisms for chronic pain and the transition from acute to chronic pain are under investigation. A number of modalities can be used in clinical practice and/or research to capture various dimensions of pain. Selection of a pain-assessment tool should be directed by the purpose of the assessment. Pain-assessment tools, many of which are currently in the early stages of validation, are discussed here. Development and validation of these multimodal tools is crucial for developing improved understanding of SCD pain and its management.

scholarly journals Pain in Advanced Stages of Dementia: The Perspective of Medical Students

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 116 ◽  
Author(s):  
Agnieszka Neumann-Podczaska ◽  
Slawomir Tobis ◽  
Lyudmila Yermukhanova ◽  
Katarzyna Wieczorowska-Tobis
Keyword(s):  
Medical Students ◽  
Pain Assessment ◽  
Assessment Tool ◽  
Pain Treatment ◽  
International Association ◽  
Activity Patterns ◽  
Pain Scale ◽  
Advanced Dementia ◽  
Assessment And Treatment ◽  
Advanced Stages

Background and objective: The number of studies related to medical students’ attitude toward pain is limited. The aim of our study was, thus, to assess the medical students’ knowledge of pain assessment and treatment in advanced stages of dementia in order to improve the existing curriculum in this area. Material and methods: We analyzed the medical students’ knowledge about pain in advanced dementia based on a short questionnaire. The research was anonymous. The questionnaire was completed by 147 students. Results: The students most often suggested that pain in patients with advanced dementia could be manifested via body language and facial expression (107 students—72.8% and 100 students—68.0%, respectively). Vocalization was the third most frequently reported pain manifestation (84–57.1%). Other groups of pain symptoms (changes in activity patterns, changes in interpersonal interactions, and mental status changes) were indicated less often (p < 0.0001). Only five students (3.4%) listed the DOLOPLUS behavioral pain scale as an assessment tool for patients with advanced dementia, and 16 (10.9%) indicated observational scale elements or a necessity to observe the patient. Still, 110 students (74.5%) correctly characterized pain treatment in patients with advanced dementia. Conclusions: To the best of our knowledge, our study is pioneering in defining the deficits of medical students’ knowledge on pain assessment and treatment in patients with advanced dementia. We highlighted knowledge gaps in the area of pain assessment which might make medical students incapable of proper pain treatment. Following the International Association for the Study of Pain considerations regarding the need for excellence in pain education, these results can contribute to the improvement of existing medical curricula in Poznan University of Medical Sciences to include pain management in dementia in a more ”patient-centered” way in order to increase future staff’s competency and to assure a better quality of care.

scholarly journals Concussion in para sport: the first position statement of the Concussion in Para Sport (CIPS) Group

2021 ◽  
pp. bjsports-2020-103696
Author(s):  
Richard Weiler ◽  
Cheri Blauwet ◽  
David Clarke ◽  
Kristine Dalton ◽  
Wayne Derman ◽  
...  
Keyword(s):  
Consensus Statement ◽  
Assessment Tool ◽  
Return To Sport ◽  
Position Statement ◽  
Assessment Tools ◽  
Future Research ◽  
Concussion Management ◽  
Rule Changes ◽  
Specific Rule ◽  
And Performance

Concussion is a frequent injury in many sports and is also common in para athletes. However, there is a paucity of concussion research related to para sport, and prior International Concussion in Sport (CIS) consensus papers have not substantively addressed this population. To remedy this and to improve concussion care provided to para athletes, the concussion in para sport (CIPS) multidisciplinary expert group was created. This group analysed and discussed in-depth para athlete-specific issues within the established key clinical domains of the current (2017) consensus statement on CIS. Due to the onset of the COVID-19 pandemic, the group held all meetings by video conferencing. The existing Sport Concussion Assessment Tool 5 (SCAT5) for the immediate on-field and office-based off-field assessment of concussion was evaluated as part of this process, to identify any para athlete-specific concerns. Regular preparticipation and periodic health examinations are essential to determine a baseline reference point for concussion symptoms but pose additional challenges for the interpreting clinician. Further considerations for concussion management for the para athlete are required within the remove, rest, reconsider and refer consensus statement framework. Considering return to sport (RTS), the 2017 CIS consensus statement has limitations when considering the RTS of the para athlete. Case-by-case decision making related to RTS following concussion is imperative for para athletes. Additional challenges exist for the evaluation and management of concussion in para athletes. There is a need for greater understanding of existing knowledge gaps and attitudes towards concussion among athlete medical staff, coaches and para athletes. Future research should investigate the use and performance of common assessment tools in the para athlete population to better guide their clinical application and inform potential modifications. Concussion prevention strategies and sport-specific rule changes, such as in Para Alpine Skiing and Cerebral Palsy Football, also should be carefully considered to reduce the occurrence of concussion in para athletes.

scholarly journals Prospective Study Evaluating a Pain Assessment Tool in a Postoperative Environment: Protocol for Algorithm Testing and Enhancement (Preprint)

2020 ◽  
Author(s):  
Emad Kasaeyan Naeini ◽  
Mingzhe Jiang ◽  
Elise Syrjälä ◽  
Michael-David Calderon ◽  
Riitta Mieronkoski ◽  
...  
Keyword(s):  
Electrical Activity ◽  
Pain Assessment ◽  
Assessment Tool ◽  
Elective Surgery ◽  
Electrodermal Activity ◽  
Vital Signs ◽  
Assessment Tools ◽  
Second Phase ◽  
Moderate Pain ◽  
Management Interventions

BACKGROUND Assessment of pain is critical to its optimal treatment. There is a high demand for accurate objective pain assessment for effectively optimizing pain management interventions. However, pain is a multivalent, dynamic, and ambiguous phenomenon that is difficult to quantify, particularly when the patient’s ability to communicate is limited. The criterion standard of pain intensity assessment is self-reporting. However, this unidimensional model is disparaged for its oversimplification and limited applicability in several vulnerable patient populations. Researchers have attempted to develop objective pain assessment tools through analysis of physiological pain indicators, such as electrocardiography, electromyography, photoplethysmography, and electrodermal activity. However, pain assessment by using only these signals can be unreliable, as various other factors alter these vital signs and the adaptation of vital signs to pain stimulation varies from person to person. Objective pain assessment using behavioral signs such as facial expressions has recently gained attention. OBJECTIVE Our objective is to further the development and research of a pain assessment tool for use with patients who are likely experiencing mild to moderate pain. We will collect observational data through wearable technologies, measuring facial electromyography, electrocardiography, photoplethysmography, and electrodermal activity. METHODS This protocol focuses on the second phase of a larger study of multimodal signal acquisition through facial muscle electrical activity, cardiac electrical activity, and electrodermal activity as indicators of pain and for building predictive models. We used state-of-the-art standard sensors to measure bioelectrical electromyographic signals and changes in heart rate, respiratory rate, and oxygen saturation. Based on the results, we further developed the pain assessment tool and reconstituted it with modern wearable sensors, devices, and algorithms. In this second phase, we will test the smart pain assessment tool in communicative patients after elective surgery in the recovery room. RESULTS Our human research protections application for institutional review board review was approved for this part of the study. We expect to have the pain assessment tool developed and available for further research in early 2021. Preliminary results will be ready for publication during fall 2020. CONCLUSIONS This study will help to further the development of and research on an objective pain assessment tool for monitoring patients likely experiencing mild to moderate pain. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17783

Instruments for pain assessment in patients with advanced dementia: A systematic review of the evidence for Latin America

2020 ◽  
Vol 18 (6) ◽  
pp. 741-747
Author(s):  
Silvia Mercedes Coca ◽  
Roberto Ariel Abeldaño Zuñiga
Keyword(s):  
Systematic Review ◽  
Latin American ◽  
Pain Assessment ◽  
Pain Treatment ◽  
Lewy Bodies ◽  
Reliability And Validity ◽  
Pain Scale ◽  
Elderly Persons ◽  
Advanced Dementia ◽  
People With Dementia

AbstractObjectivePain treatment is an essential component of care for elderly patients with advanced dementia. The objective of this study was to identify and analyze the different scales used for pain assessment in elderly persons diagnosed with dementia, in the literature available at the Latin American level.MethodA systematic review was performed on the existing scales for pain assessment in elderly people diagnosed with Alzheimer's disease, vascular dementia, and dementia with Lewy bodies.Results226 articles were retrieved from the PUBMED, BIREME, and Scielo databases, of which a total of 10 articles entered the systematic review. The instruments identified in these publications were PAINAD, Abbey, McGill, and PACSLAC, while the Colored Pain Scale, Faces Pain Scale, and VAS scales were used as the silver standard. In Spanish, the Abbey scale, and in Portuguese, the PACSLAC scale showed the best reliability and validity coefficients.Significance of resultsIt is concluded that there are only two appropriate scales for the assessment of pain in people with dementia in the region of interest of this study. It is recommended to generate more evidence for a more accurate assessment of pain in people with dementia.

Evaluation of Pain Assessment Tools in Patients Receiving Mechanical Ventilation

2016 ◽  
Vol 27 (2) ◽  
pp. 162-172 ◽  
Author(s):  
Zainab Q. Al Darwish ◽  
Radwa Hamdi ◽  
Summayah Fallatah
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Pain Assessment ◽  
Descriptive Study ◽  
Pain Scale ◽  
Assessment Tools ◽  
Highly Sensitive ◽  
Sensitive Tool ◽  
P 16 ◽  
Behavioral Pain Scale

Pain assessment poses a great challenge for clinicians in intensive care units. This descriptive study aimed to find the most reliable, sensitive, and valid tool for assessing pain. The researcher and a nurse simultaneously assessed 47 nonverbal patients receiving mechanical ventilation in the intensive care unit by using 3 tools: the Behavioral Pain Scale (BPS), the Critical-Care Pain Observation Tool (CPOT), and the adult Nonverbal Pain Scale (NVPS) before, during, and after turning and suctioning. All tools were found to be reliable and valid (Cronbach α = 0.95 for both the BPS and the CPOT, α = 0.86 for the NVPS), and all subscales of both the BPS and CPOT were highly sensitive for assessing pain (P &lt; .001). The NVPS physiology (P = .21) and respiratory (P = .16) subscales were not sensitive for assessing pain. The BPS was the most reliable, valid, and sensitive tool, with the CPOT considered an appropriate alternative tool for assessing pain. The NVPS is not recommended because of its inconsistent psychometric properties.

scholarly journals Psychotic-Like Experiences: A Challenge in Definition and Assessment

2021 ◽  
Vol 12 ◽  
Author(s):  
Barbara Hinterbuchinger ◽  
Nilufar Mossaheb
Keyword(s):  
Psychotic Disorders ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Psychotic Symptoms ◽  
Future Research ◽  
Psychotic Experiences ◽  
Standard Assessment ◽  
Conceptual Clarity ◽  
Persistence Rates ◽  
Definition Of

Assuming a continuum between psychotic experiences and psychotic symptoms aligned between healthy individuals and patients with non-psychotic and psychotic disorders, recent research has focused on subclinical psychotic experiences. The wide variety of definitions, assessment tools, and concepts of psychotic-like experiences (PLEs) might contribute to the mixed findings concerning prevalence and persistence rates and clinical impact. In this narrative review, we address the panoply of terminology, definitions, and assessment tools of PLEs and associated concerns with this multitude. Moreover, the ambiguous results of previous studies regarding the clinical relevance of PLEs are described. In conclusion, we address clinical implications and highly suggest conceptual clarity and consensus concerning the terminology and definition of PLEs. The development of an agreed upon use of a “gold standard” assessment tool seems essential for more comparable findings in future research.

Knowledge and practice regarding neonatal pain management in the opinion of nurses and midwives working in Polish neonatal units

Ból ◽  
2019 ◽  
Vol 19 (3) ◽  
pp. 1-9
Author(s):  
Magdalena Panek ◽  
Przemko Kwinta
Keyword(s):  
Pain Assessment ◽  
Pain Treatment ◽  
Assessment Tools ◽  
Basic Knowledge ◽  
Significance Level ◽  
Neonatal Pain ◽  
Frequent Use ◽  
Frequency Of Use ◽  
Assessment And Treatment ◽  
Nurses And Midwives

Nurses and midwives working in neonatal units play a key role in the assessment and treatment of pain. Due to their nature of work, which is based on continuous observation of the patient, they constitute a professional group that responds to changes in the child’s general condition. Thanks to this, the physicians get information about pain intensity or the need of pain treatment, which is relevant among patients who cannot report any symptoms of pain by themselves. The aim of the study was to describe nurses’ and midwives’ basic knowledge about pain and the practice regarding procedural pain assessment and management in Polish neonatal care units. The studies were carried out among 617 nurses and midwives working in neonatal units in Poland. We collected data by using a researcher-developed questionnaire. The significance level was set at p<0.5. 30% of nurses never used non-pharmacological methods of pain relief before painful procedures. Moreover, the higher the level of reference, the more often no non-pharmacological methods were used. Knowledge related to the basic problems associated with pain can be described as insufficient (Me = 4). Frequent use of sedation drugs has also been reported (III level NICU: phenobarbital po / pr: 72.8% of respondents, opioids - 34.9%, II level NICU: phenobarbital po / pr 45.2%, opioids: 4.5%). The longer nurses and midwives worked, the lower the frequency of use of pain assessment tools was (p = 0.0048, R = -0.113). The lack of appropriate pharmacological and nonpharmacological pain treatment and lack of use of pain scales are a significant problem in the care of newborns. Our research indicates the need for education in the field of pain assessment and treatment methods in newborns.

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