Reliability and Feasibility of the Pain Assessment in Advanced Dementia Scale–Korean Version (PAINAD-K)

Background: There is currently no observational instrument for assessing pain in aged patients who are unable to provide self-report in long-term care hospitals in Korea. Aims: The goal of this research was to culturally adapt and test the validity, reliability, and feasibility of the Korean version of the Pain Assessment in Advanced Dementia Scale. Design: This was a methodologic study aiming to translate the Pain Assessment in Advanced Dementia Scale. Participants/Subjects: The inpatients in a 270-bed LTC hospital in D metropolitan city were assessed pain levels. Methods: The Pain Assessment in Advanced Dementia (PAINAD) Scale was used as an observation scale to assess 192 long-term care hospital patients, with observation durations of 1 and 5 minutes. Results: The interrater reliability (1 minute) for the scale showed substantial kappa agreement of.62, and scores for the 1- and 5-minute observations showed almost perfect agreement of.95. The criterion validity of the scale (1 minute) was high relative to the Face-Legs-Activity-Cry-Consolability (FLACC) Scale, and low compared with the numeric rating scale (NRS). Discriminant validity was established between patients with and without pain. The feasibility of the Pain Assessment in Advanced Dementia Scale–Korean Version (PAINAD-K) (1 minute) indicated low sensitivity of 41.3% and high specificity of 92.6%. Conclusions: Therefore, the PAINAD-K is a valid and reliable tool to determine the absence of pain in non-verbal aged patients.