• Sharon Kaasalainen, Noori Akhtar-Danesh, Thomas Hadjistavropoulos, Sandra Zwakhalen, and Rene Verreault.
• School of Nursing, McMaster University, Hamilton, Ontario. Electronic address: kaasal@mcmaster.ca.
• Pain Manag Nurs. 2013 Dec 1;14(4):e106-14.

AbstractThe purpose of this study was twofold: (1) to evaluate four pain assessment tools for use with long-term care (LTC) residents who were both able and not able to verbally report their pain; and (2) to assess whether pain behaviors displayed by LTC residents vary as a function of ability to self-report pain. We examined the differences between these two groups of residents in terms of specific pain behaviors assessed through the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) and Pain Assessment in the Communicatively Impaired (PACI). We also examined the interrater reliability, and concurrent and construct validity of these two behavioral observation tools and the concurrent and construct validity of the two verbal report tools. Data were collected from a convenience sample of 338 residents from six LTC homes. The interrater reliabilities for the two behavioral observation tools were good, and concurrent validity was supported for all four pain assessment tools. Pain behaviors, as assessed by the PACSLAC and PACI, varied as a function of resident ability to verbally report pain. Residents with inability to self-report pain are more nonverbally responsive, although certain behaviors (such as guarding and touching the affected area) are seen more frequently in those capable of self-report. Our data also provide psychometric support for the assessment methods used in this study.Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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