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首页> 外文期刊>BMC Geriatrics >Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools
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Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools

机译：痴呆症患者的疼痛评估：对疼痛评估工具的系统评价的系统评价

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Background There is evidence of under-detection and poor management of pain in patients with dementia, in both long-term and acute care. Accurate assessment of pain in people with dementia is challenging and pain assessment tools have received considerable attention over the years, with an increasing number of tools made available. Systematic reviews on the evidence of their validity and utility mostly compare different sets of tools. This review of systematic reviews analyses and summarises evidence concerning the psychometric properties and clinical utility of pain assessment tools in adults with dementia or cognitive impairment. Methods We searched for systematic reviews of pain assessment tools providing evidence of reliability, validity and clinical utility. Two reviewers independently assessed each review and extracted data from them, with a third reviewer mediating when consensus was not reached. Analysis of the data was carried out collaboratively. The reviews were synthesised using a narrative synthesis approach. Results We retrieved 441 potentially eligible reviews, 23 met the criteria for inclusion and 8 provided data for extraction. Each review evaluated between 8 and 13 tools, in aggregate providing evidence on a total of 28 tools. The quality of the reviews varied and the reporting often lacked sufficient methodological detail for quality assessment. The 28 tools appear to have been studied in a variety of settings and with varied types of patients. The reviews identified several methodological limitations across the original studies. The lack of a ‘gold standard’ significantly hinders the evaluation of tools’ validity. Most importantly, the samples were small providing limited evidence for use of any of the tools across settings or populations. Conclusions There are a considerable number of pain assessment tools available for use with the elderly cognitive impaired population. However there is limited evidence about their reliability, validity and clinical utility. On the basis of this review no one tool can be recommended given the existing evidence.
机译：背景技术有证据表明，在长期和急性护理中，痴呆患者的疼痛检测不足且管理不善。对痴呆症患者的疼痛进行准确的评估具有挑战性，多年来，疼痛评估工具受到了相当大的关注，提供的工具越来越多。关于其有效性和实用性的系统评价大多比较了不同的工具集。这篇系统评价的综述分析并总结了有关痴呆症或认知障碍成人疼痛评估工具的心理测量特性和临床效用的证据。方法我们搜索了疼痛评估工具的系统评价，以提供可靠性，有效性和临床实用性的证据。两名审稿人独立评估每个审稿并从中提取数据，第三名审稿人在未达成共识时进行调解。数据分析是协作进行的。评论是使用叙述性综合方法进行综合的。结果我们检索了441项可能符合条件的评论，其中23篇符合纳入标准，8篇提供了提取数据。每次审查评估了8到13种工具，总共提供了总共28种工具的证据。评审的质量各不相同，报告通常缺乏足够的方法论细节来进行质量评估。这28种工具似乎已在各种场合和不同类型的患者中进行了研究。审查确定了整个原始研究的几种方法学局限性。缺乏“黄金标准”严重阻碍了对工具有效性的评估。最重要的是，样本很小，为跨环境或总体使用任何工具提供了有限的证据。结论有大量的疼痛评估工具可用于老年认知障碍人群。然而，关于其可靠性，有效性和临床实用性的证据有限。在此审查的基础上，鉴于现有证据，不能推荐任何一种工具。

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