Concurrent validity of Thai version of pain assessment in advanced dementia scale versus self reported pain in cognitively impaired and intact geriatric surgical patients

Abstract

Accurate pain assessment is essential for the effective pain management of geriatric patients. This study evaluated the concurrent validity of the Pain Assessment in Advanced Dementia–Thai version (PAINAD-Th), against self-reported pain in postoperative geriatric patients. Additionally, we examined the utility of the PAINAD-Th for assessing pain response to analgesic intervention. This descriptive correlational design study was conducted at a Thai tertiary care hospital. A total of 208 geriatric patients underwent cognitive function assessment via the Thai Mental State Examination (TMSE). Self-reported pain scores (using the verbal descriptor scale [VDS] and Numerical Rating Scale [NRS]) and PAINAD-Th scores were recorded in the postanesthetic care unit and on the first postoperative day in the ward. The data analysis focused on the concurrent validity of self-report pain scales and the PAINAD-Th, and the latter’s sensitivity in detecting pain reduction following analgesic treatment. The mean patient age was 77.6 years, and the mean TMSE score was 23.9. A strong correlation existed between the VDS and the PAINAD-Th scores in both cognitively impaired and cognitively intact patients (0.876 and 0.696, respectively; p < 0.001). The NRS and PAINAD-Th scores were moderately correlated in patients with mild to moderate cognitive impairment and intact cognition (0.58 and 0.63, respectively; p < 0.001). Importantly, both the PAINAD-Th and NRS scores decreased significantly following analgesic administration. The PAINAD-Th is a useful alternative pain assessment tool for the postoperative pain management of geriatric patients. This holds true for both cognitively impaired and intact patients who may struggle to provide self-reported pain scores.