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Validation of Doloplus-2 among nonverbal nursing home patients : an evaluation of Doloplus-2 in a clinical setting

Torvik, Karin; Kaasa, Stein; Kirkevold, Øyvind; Saltvedt, Ingvild; Hølen, Jacob Christian; Fayers, Peter; Rustøen, Tone
Journal article, Peer reviewed
This is an open access article distributed under the terms of the creative commons attribution license (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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URI
https://hdl.handle.net/10642/586
Date
2010-02-20
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  • HV - Institutt for sykepleie og helsefremmende arbeid [1297]
Original version
Torvik, K., Kaasa, S., Kirkevold, Ø., Saltvedt, I., Hølen, J.K., Fayers, P. & Rustøen, T. (2010). Validation of Doloplus-2 among nonverbal nursing home patients : an evaluation of Doloplus-2 in a clinical setting. BMC Geriatrics, 10 (9)   http://dx.doi.org/10.1186/1471-2318-10-9
Abstract
Background: Pain measurement in nonverbal older adults is best based on behavioural observation, e.g. using an

observational measurement tool such as Doloplus-2. The purposes of this study were to examine the use of

Doloplus-2 in a nonverbal nursing home population, and to evaluate its reliability and validity by comparing

registered nurses’ estimation of pain with Doloplus-2 scores.

Method: In this cross-sectional study, Doloplus-2 was used to observe the pain behaviour of patients aged above

65 years who were unable to self-report their pain. Nurses also recorded their perceptions of patient pain (yes, no,

don’t know) before they used Doloplus-2. Data on demographics, medical diagnoses, and prescribed pain

treatment were collected from patient records. Daily life functioning was measured and participants were screened

using the Mini Mental State Examination.

Results: In total, 77 nursing home patients were included, 75% were women and the mean age was 86 years (SD

6.6, range 68-100). Over 50% were dependent on nursing care to a high or a medium degree, and all were

severely cognitively impaired. The percentage of zero scores on Doloplus-2 ranged from 17% (somatic reactions) to

40% (psychosocial reactions). Cronbach’s alpha was 0.71 for the total scale. In total, 52% of the patients were

judged by nurses to be experiencing pain, compared with 68% when using Doloplus-2 (p = 0.01). For 29% of the

sample, nurses were unable to report if the patients were in pain.

Conclusions: In the present study, more patients were categorized as having pain while using Doloplus-2

compared with nurses’ estimation of pain without using any tools. The fact that nurses could not report if the

patients were in pain in one third of the patients supports the claim that Doloplus-2 is a useful supplement for

estimating pain in this population. However, nurses must use their clinical experience in addition to the use of

Doloplus-2, as behaviour can have different meaning for different patients. Further research is still needed about

the use of Doloplus-2 in patients not able to self-report their pain.
Publisher
BioMed Central
Series
BMC Geriatrics;10 (9)

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