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Panuccio F, Rossi G, Di Nuzzo A, Ruotolo I, Cianfriglia G, Simeon R, Sellitto G, Berardi A, Galeoto G. Quality of Assessment Tools for Aphasia: A Systematic Review. Brain Sci 2025; 15:271. [PMID: 40149792 PMCID: PMC11940547 DOI: 10.3390/brainsci15030271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2025] [Revised: 02/17/2025] [Accepted: 02/25/2025] [Indexed: 03/29/2025] Open
Abstract
Background/Objectives: Aphasia is a neurological condition affecting the ability to understand and/or express language fluently and accurately, and can occur following stroke, traumatic injuries, or other brain pathologies. The aim of the following study was to provide clinicians and researchers information regarding the existing assessment tools to assess aphasia. Methods: For this Systematic Review, PubMed, CINAHL, Web of Science, and Scopus were searched for articles published up to August 2024. Authors independently identified eligible studies based on predefined inclusion criteria and extracted data. The study quality and risk of bias were assessed using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Results: Of the 1278 publications identified and screened, 238 studies fell within the inclusion criteria and were critically reviewed, and 164 assessment tools were found and divided into 8 main domains; the most used tools were the Language Screening Test (LAST), the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39), the Oxford Cognitive Screen (OCS), and the Token test. Conclusions: This review has emphasized the need for agreement among researchers as to which tool must be studied or adapted to other national contexts to develop universal norms and standards.
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Affiliation(s)
- Francescaroberta Panuccio
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università, 30, 00185 Rome, Italy; (F.P.); (G.R.); (A.D.N.); (I.R.); (G.C.); (G.S.); (A.B.)
| | - Giulia Rossi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università, 30, 00185 Rome, Italy; (F.P.); (G.R.); (A.D.N.); (I.R.); (G.C.); (G.S.); (A.B.)
| | - Anita Di Nuzzo
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università, 30, 00185 Rome, Italy; (F.P.); (G.R.); (A.D.N.); (I.R.); (G.C.); (G.S.); (A.B.)
| | - Ilaria Ruotolo
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università, 30, 00185 Rome, Italy; (F.P.); (G.R.); (A.D.N.); (I.R.); (G.C.); (G.S.); (A.B.)
- Department of Public Sciences and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Giada Cianfriglia
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università, 30, 00185 Rome, Italy; (F.P.); (G.R.); (A.D.N.); (I.R.); (G.C.); (G.S.); (A.B.)
| | - Rachele Simeon
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, 16126 Genoa, Italy;
| | - Giovanni Sellitto
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università, 30, 00185 Rome, Italy; (F.P.); (G.R.); (A.D.N.); (I.R.); (G.C.); (G.S.); (A.B.)
- Department of Public Sciences and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università, 30, 00185 Rome, Italy; (F.P.); (G.R.); (A.D.N.); (I.R.); (G.C.); (G.S.); (A.B.)
- IRCCS Neuromed, Via Atinense, 18, 86077 Pozzilli, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università, 30, 00185 Rome, Italy; (F.P.); (G.R.); (A.D.N.); (I.R.); (G.C.); (G.S.); (A.B.)
- IRCCS Neuromed, Via Atinense, 18, 86077 Pozzilli, Italy
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McLennan AIG, Castillo LIR, Hadjistavropoulos T. Pain in Dementia: An Empirical Test of a Common Assumption. THE JOURNAL OF PAIN 2024; 25:104605. [PMID: 38880391 DOI: 10.1016/j.jpain.2024.104605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/06/2024] [Accepted: 06/08/2024] [Indexed: 06/18/2024]
Abstract
Numerous, and often largely overlapping, observational pain assessment tools have been developed specifically to assess pain in older adults with dementia under the assumption that a specialized approach is necessary to evaluate pain in this population. However, this assumption has never been tested empirically. As an empirical test of this implicit assumption, our goal was to compare existing tools for people living with dementia (with respect to psychometric properties), not only against each other, but also against a tool developed for a different population with cognitive impairments. Videos of older adults with severe dementia recorded in long-term care settings were coded for pain behaviors in the laboratory. Trained coders coded pain behaviors in video segments of older adults with dementia during a quiet baseline condition as well as during a physical examination (designed to identify painful areas), using various observational pain assessment tools. An observational measure of agitation was employed to facilitate the assessment of discriminant validity. Consistent with our expectations, all pain tools (including the tool developed for younger people with cognitive impairments) successfully differentiated between painful and nonpainful states, with large effect sizes. This was the first study to compare tools specifically developed to assess pain in people living with dementia to a tool developed for a different population. Given that all tools under study showed satisfactory psychometric properties when tested on persons with dementia, this study suggests that the assumption that different tools are necessary for different populations with cognitive impairments cannot be taken for granted. PERSPECTIVE: This article challenges an implicitly held assumption that specialized tools are needed to assess pain in different populations with cognitive impairments. Given commonalities in pain expression across populations, further research is needed to determine whether population-specific tools are needed.
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Affiliation(s)
- Andrew I G McLennan
- Department of Psychology and Centre of Aging and Health, University of Regina, Regina, Saskatchewan, Canada
| | - Louise I R Castillo
- Department of Psychology and Centre of Aging and Health, University of Regina, Regina, Saskatchewan, Canada
| | - Thomas Hadjistavropoulos
- Department of Psychology and Centre of Aging and Health, University of Regina, Regina, Saskatchewan, Canada.
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Sabater-Gárriz Á, Molina-Mula J, Montoya P, Riquelme I. Pain assessment tools in adults with communication disorders: systematic review and meta-analysis. BMC Neurol 2024; 24:66. [PMID: 38368314 PMCID: PMC10873938 DOI: 10.1186/s12883-024-03539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/15/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND Verbal communication is the "gold standard" for assessing pain. Consequently, individuals with communication disorders are particularly vulnerable to incomplete pain management. This review aims at identifying the current pain assessment instruments for adult patients with communication disorders. METHODS A systematic review with meta-analysis was conducted on PubMed, PEDRO, EBSCOhost, VHL and Cochrane databases from 2011 to 2023 using MeSH terms "pain assessment, "nonverbal communication" and "communication disorders" in conjunction with additional inclusion criteria: studies limited to humans, interventions involving adult patients, and empirical investigations. RESULTS Fifty articles were included in the review. Seven studies report sufficient data to perform the meta-analysis. Observational scales are the most common instruments to evaluate pain in individuals with communication disorders followed by physiological measures and facial recognition systems. While most pain assessments rely on observational scales, current evidence does not strongly endorse one scale over others for clinical practice. However, specific observational scales appear to be particularly suitable for identifying pain during certain potentially painful procedures, such as suctioning and mobilization, in these populations. Additionally, specific observational scales appear to be well-suited for certain conditions, such as mechanically ventilated patients. CONCLUSIONS While observational scales dominate pain assessment, no universal tool exists for adults with communication disorders. Specific scales exhibit promise for distinct populations, yet the diverse landscape of tools hampers a one-size-fits-all solution. Crucially, further high-quality research, offering quantitative data like reliability findings, is needed to identify optimal tools for various contexts. Clinicians should be informed to select tools judiciously, recognizing the nuanced appropriateness of each in diverse clinical situations. TRIAL REGISTRATION This systematic review is registered in PROSPERO (International prospective register of systematic reviews) with the ID: CRD42022323655 .
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Affiliation(s)
- Álvaro Sabater-Gárriz
- Balearic ASPACE Foundation, Marratxí, Spain
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, 07122, Spain
- Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, Palma, 07122, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, 07010, Spain
| | - Jesús Molina-Mula
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, 07122, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, 07010, Spain
| | - Pedro Montoya
- Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, Palma, 07122, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, 07010, Spain
| | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, 07122, Spain.
- Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, Palma, 07122, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), Palma, 07010, Spain.
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Zare M, Tagharrobi Z, Sharifi K, Sooki Z, Abolhasani J. Psychometric evaluation of the Persian version of the Doloplus-2 (P-Doloplus-2) scale in elderly with dementia. Turk J Med Sci 2020; 50:953-962. [PMID: 32394680 PMCID: PMC7379415 DOI: 10.3906/sag-2001-117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/05/2020] [Indexed: 11/03/2022] Open
Abstract
Background/aim A scale for behavioural pain assessment is useful for the detection and determination of pain in the elderly with
dementia. This study aimed to translate and evaluate the psychometric properties of Doloplus-2 in the elderly with dementia in Iran. Materials and methods In this methodological study, after translation and evaluating the face and content validity of Doloplus-2, 100 elderly people were selected by the convenience sampling method in Kashan, 2018–2019. Exploratory factor analysis, convergent validity, and known-groups comparison were applied to determine construct validity. Reliability was also assessed through internal consistency, equivalence, and stability methods were used. The ceiling and floor effects were also examined. Data were analyzed using the SPSS-v16 and via Mann-Whitney U test, Cronbach’s alpha, Spearman-Brown, and intraclass correlation coefficient (ICC). Results The scale’s content validity index was 0.95%, and the item impact of each item was above 1.5. Factor analysis identified 2 “social- functional” and “conventional subjective-objective” factors in scale that altogether were able to explain 76% of the total variance. The results revealed that P-Doloplus-2 could discriminate between the 2 groups of elderly with and without known chronic painful diseases (P < 0.0001). There was a significant positive correlation between P-Doloplus-2 and PACSLAC-II-IR scores (r = 0.878, P < 0.0001). Cronbach’s alpha, ICC, and standard error of measurement for the scale were 0.950, 0.864, and ± 1.759, respectively. The frequency of minimum and maximum possible score of scale was less than 15%. Conclusion The Persian version of Doloplus-2 can be considered as a valid and reliable scale for pain assessment in the elderly with dementia.
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Affiliation(s)
- Mohammad Zare
- Trauma Nursing Research Centre, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Tagharrobi
- Trauma Nursing Research Centre, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Khadijeh Sharifi
- Trauma Nursing Research Centre, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Sooki
- Trauma Nursing Research Centre, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Javad Abolhasani
- Department of Neurology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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