Mar 19, 2011

Pain in the elderly: validity of facial expression components of observational measures

The Clinical Journal of Pain
Esther SheuKenneth D Craig

Abstract

Assessing pain in elderly persons, who have diminished capacity to communicate verbally, requires use of observational scales that focus upon nonverbal behavior. Facial expression has been recognized as providing the most specific and sensitive nonverbal cues for pain. This study examined the validity of facial expression components of 6 widely used pain assessment scales developed for elders with dementia. Descriptions of the facial expression of pain vary widely on these scales. The detailed, anatomically based, objectively coded, and validated Facial Action Coding System was used as a criterion index to provide a definitive description of the facial expression of pain. Thirty elderly inpatients with clinically significant pain in the back or hip, the majority of whom had cognitive impairments, provided videotaped reactions to physical activities. Participants' facial expressions were videotaped during 4 randomly ordered physical activities and coded by a qualified Facial Action Coding System coder. Three 6-second clips indicative of mild, moderate, and severe pain intensities were selected for study for each participant. The 90 clips were coded by 5 raters using the facial expression components of the following observational...Continue Reading

  • References32
  • Citations29

Citations

Mentioned in this Paper

Visual Analog Pain Scale
Facial Expression
Severe Pain
Senility
Videocassette
Observation - Diagnostic Procedure
Observation in Research
Pain Measurement
Elder extract
Dementia

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