Physiological Biomarkers for Assessment of Pain during Routine Blood Tests for Older Adults with Dementia in Long-Term Residential Care.

Autor:	Feng PC; Master Degree Program in Health and Long-term Care Industry, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan., Khan MA; Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan., Yeh TT; Master Degree Program in Health and Long-term Care Industry, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan., Shieh WY; Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan., Tsai HH; School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. Electronic address: kitty@mail.cgu.edu.tw.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2024 Aug; Vol. 25 (8), pp. 105050. Date of Electronic Publication: 2024 May 31.
DOI:	10.1016/j.jamda.2024.105050
Abstrakt:	Objective: Evaluating pain in individuals with dementia can be difficult when verbal communication is limited. Vocalization has emerged as a potential avenue for assessments of pain in nonverbal populations. This study aimed to evaluate if physiological assessments of vocalization were correlated with observational assessments of pain during routine blood tests for persons with dementia. Design: A cross-sectional descriptive study. Setting and Participants: Sixty older adults (aged ≥65 years old) with dementia requiring routine finger puncture and peripheral venipuncture for routine blood tests were recruited by purposive sampling from 3 long-term care facilities in Taiwan. Methods: Observational assessments were conducted with the Pain Assessment in Advanced Dementia (PAINAD) instrument; physiological biomarkers of vocalization were assessed with a noninvasive sensing device and microphone (NISDM). Assessments were conducted simultaneously in one session during situations of increasing pain levels: at rest, making a sound, finger puncture, and peripheral venipuncture. PAINAD scores were compared with signal recording measures from the NISDM. Analysis of variance and Pearson correlation coefficient assessed correlations between observational and physiological measures. Results: Most participants were female (63.3%); mean age was 81.27 years (SD = 9.69); Clinical Dementia Rating was 2.23 ± 0.70; and Mini-Mental State Examination was 7.07 ± 6.95. Signal recording measures using the NISDM during finger puncture and venipuncture were significantly greater compared with measures at rest and making sound, indicating higher signal levels were associated with pain. PAINAD scores were significantly correlated with physiological measures for vocalization variables of sound amplitude (r = 0.49, P < .001), shimmer (r = 0.63, P < .001), and inhalation-to-exhalation amplitude ratio (r = 0.48, P < .001). Conclusions and Implications: Elevated vocalizations detected with the NISDM were correlated with increased pain scores on the PAINAD instrument. Physiological measures of pain using novel vocalization biomarkers have the potential to enhance the quality of care for individuals with dementia and limited communication abilities. Competing Interests: Disclosure The authors declare no conflicts of interest. (Copyright © 2024 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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