Measured Factor Detail
Abbey pain scale assessment tool provides the description of the severity of pain in dementia patients with calculated scores being classified based on the type of pain such as acute, chronic and acute on chronic. The calculation of score takes into account patient features such as vocalization, facial expression, body language, physical changes and physiological changes.
Pain Management Specialist
Multiple body systems
Measured Factor Low Impact
- Pain score 0-2 is indicative of no pain.
Measured Factor High Impact
- Pain score 3-7 illustrates mild pain
- 8-13 indicates illustrates moderate pain
- score more than 14 illustrates severe pain
- Critical High: 3
- Normal: 0-2
- Normal Adult Male: 0-2
- Normal Adult Female: 0-2
- Normal Geriatric Male: 0-2
- Normal Geriatric Female: 0-2
This test does not distinguish between distress and pain and it is reliant upon the nursing staff's interpretation of what the patient is experiencing. It has been suggested that The Abbey Pain Scale should be used in conjunction with the Assessment of Discomfort in Dementia (ADD) protocol that focuses on physical assessment, review of the patient's history, assessment of affective needs and the administration of analgesics.
Study Validation 1
The study was conducted on population that consisted of 50 old patients (70+ years), consecutively admitted to the geriatric wards of Aarhus University Hospital, Denmark fulfilling one of the following inclusion criteria: Mini Mental State Examination (MMSE) < 5, delirium, non-communicative aphasia, or unconsciousness. Abbeys pain scale (APS) has six subscales and ranges from 0 (no pain) to 18 (worst pain). Criterion validity was assessed by using Verbal Rating Scale (VRS) as the gold standard. Cohen's kappa (k) was the measure of agreement. The results of the study demonstrated that Abbeys pain assessment scale should be considered as qualified and usable in severely demented and non-communicative older patients admitted to a geriatric ward.
Study Validation 2
The Objective of this study was to develop and validate the Japanese version of the Abbey Pain Scale (APS-J), to assess pain of older adults who live in nursing homes in Japan. The data were collected from residents in two nursing homes in Japan to include: demographics, the Barthel Index, Folstein Mini-Mental Examination (MMSE), APS-J and Verbal Descriptor Scale (VDS) for pain. Two researchers independently assessed the residents' pain using the APS-J while the residents walked or were transferred from bed to wheelchair. Intraclass correlation coefficients (ICC) for inter-rater and test-retest reliability, Chronbach's alpha-value of the APS-J, and correlation between the APS-J and other variables were examined. The study evidenced reliability and validity of APS-J.
Study Validation 3
The objective of this study was to determine whether these tools can also be used to evaluate intensity of pain. Cognitively intact [Mini Mental State Examination (MMSE) ≥ 24, n = 60] and impaired people (MMSE < 20, n = 65) in nursing home facilities were included in the study. Participants were observed at rest and during a movement protocol. Directly afterwards, the observer, blinded to cognitive status, completed three behavioural pain assessment instruments (Abbey Pain Scale, Pain Assessment in Advanced Dementia Scale (PAINAD), Non-communicative Patients Pain Assessment Instrument (NOPPAIN) ], before interviewing the resident about pain self-report. The outcomes of the study indicated that the use of the Abbey Pain Scale, PAINAD or NOPPAIN improves both the recognition of pain presence/absence as well as rating pain severity in older people with impaired cognition.
Study Additional 1
In the present study a 66-year-old man of Mongolian race presented with coronary arteriosclerosis, spinal canal stenosis, transverse colon cancer, and alcoholic encephalopathy. On admission, a tortured expression and abdominal distention were observed, along with emaciation. However, the patient's tortured expression was not completely relieved; therefore, an assessment of cancer pain was considered. The Abbey Pain Scale was applied. On the basis of the patient's score, analgesics and an opioid, among other medications, were administered. These led to relief of the patient's tortured expression and reduced his Abbey Pain Scale score. Following this, the patient's vital signs continued to be stable, and he was transferred to the referral institution. The results of the study indicate that the application of the Abbey Pain Scale assists in the relief of cancer pain.
Study Additional 2
Stroke patients can experience a variety of pain. Many stroke patients have comorbidities such as osteoporosis, arthritis or diabetes causing diabetic neuropathy. As well as pain from other long term conditions, stroke patients can experience central post-stroke pain, headaches, and musculoskeletal issues such as hypertonia, contractures, spasticity, and subluxations. These stroke patients can also have communication difficulties in the form of expressive dysphasia and/or global aphasia. By implementing an observational measurement of pain such as the Abbey pain scale, patients with communication difficulties can have their pain assessed and recorded. Initially 30% of patients on the acute stroke ward did not have their pain assessed and adequately recorded and 15% of patients had inadequate pain relief. After introducing the Abbey pain scale and creating a nurse advocate, an improvement was shown such that only 5% of patients did not have their pain recorded and all had adequate pain relief.
Study Additional 3
The objective of this study was to evaluate the relative psychometric merits of the Abbey Pain Scale, the DOLOPLUS-2 Scale, and the Checklist of Nonverbal Pain Indicators Scale, three well-known pain rating scales that have previously been used to assess pain in nonverbal people with dementia. An observational study design was used. Nurses (n = 26) independently rated a cross-section of people with moderate to severe dementia (n = 126) on two occasions. The Abbey Pain Scale and the DOLOPLUS-2 Scale showed good psychometric qualities in terms of reliability and validity, including resistance to the influence of rater characteristics. The demonstrates that Abbey Pain Scale may be better suited than the other two scales for use by nurse raters who only occasionally use pain rating scales or who have lower level nursing qualifications.