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KMID : 0388320230300010090
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Journal of Korean Academy of Fundamental Nursing
2023 Volume.30 No. 1 p.90 ~ p.101
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Validation of the PAINAD-K Scale for Nonverbal Pain Assessment in the Post Anesthesia Care Unit
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Kang Hye-Min
Uhm Ju-Yeon
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Abstract
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Purpose: This study aimed to verify the reliability and validity of the Pain Assessment in Advanced DementiaScale-Korean version (PAINAD-K) for assessing pain in patients unable to communicate in the post-anesthesiacare unit (PACU).
Methods: The study included 205 patients, aged >65 years, admitted to the PACU followinggeneral surgery. Reliability was assessed using Cronbach’s α, test-retest, intraclass correlation coefficient (ICC),and kappa coefficients. Criterion validity was evaluated with concurrent validity, and receiver operatingcharacteristic (ROC) analysis assessed sensitivity and specificity. Convergent and discriminant validity wereanalyzed to verify the construct of the scale.
Results: The Cronbach’s α, ICC, and test-retest correlation valueswere .78, .95~.98, and .56~.74, respectively, indicating good reliability. At baseline, the correlation coefficient was.93 with the Algoplus scale in the non-communicative group and .82 with the numeric rating scale in thecommunicative group. Further establishing criterion validity in the nonverbal group, the area under the ROC curvewas 0.995 (sensitivity=98.4%, specificity=97.5%) at baseline and .95 (sensitivity=96.4%, specificity=93.2%) atthe 30-minute follow-up. The correlation coefficient with the Critical-Care Pain Observation Tool was .69~.96,showing convergent validity, and there was a significant interaction effect between time and group, indicatingdiscriminant validity.
Conclusion: The study findings suggest that the PAINAD-K is a psychometrically valid scalefor assessing pain in PACU patients aged >65 years who are unable to communicate.
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KEYWORD
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Emergence delirium, Pain measurement, Psychometrics
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