Adaptation and validation of the Spanish version of the pain assessment scale in people with advanced dementia

Pain is considered a serious problem in the nursing home environment affecting between 49% and 83% of residents. The evolutionary process of Alzheimer’s disease can lead to difficulties in communication and understanding of pain rating scales, making its assessment and treatment difficult. The main objective of this study was to validate the Spanish version of the PAINAD (PAINAD-Sp) and to assess its applicability in a Gerontology Centre in Spain. Material and methods: Twenty users diagnosed with advanced dementia were observed by 5 observers with different professional profiles for 5 minutes in 3 conditions: rest, during enjoyable activity and in a situation of pain. The PAINAD-Sp was administered simultaneously with a visual analogue scale.

Results: The results show that Cronbach’s alpha was between 0.467 and 0.827 (with an average of 0.692, which rose if the breathing apparatus was removed). Inter-rater reliability ranged between 0.587 and 0.956. The correlation between the total measurement in PAINAD-Sp and in a Visual Analogue Scale was statistically significant (p < 0.05) in all of the measurements and ranged between 0.517 and 0.868. Conclusions: The results of the study show that the PAINAD-Sp scale is effective for measuring pain in people with dementia without the ability to communicate. This scale can be u