Per citar aquest document: http://ddd.uab.cat/record/38116
Desarrollo de un instrumento para la valoración del dolor en personas con trastorno cognitivo grave : la escala de Evaluación del Dolor en Ancianos con Demencia (EDAD) / por Rosa Baeza Lanuza ; bajo la dirección de Josep-Eladi Baños Díez y Rafael Torrubia Beltri
Baeza Lanuza, Rosa
Baños i Díez, Josep Eladi, dir. (Universitat Autònoma de Barcelona. Departament de Farmacologia, de Terapèutica i de Toxicologia)
Torrúbia, Rafael, dir. (Universitat Autònoma de Barcelona. Departament de Psiquiatria i de Medicina Legal)

Publicació: Bellaterra : Universitat Autònoma de Barcelona, 2007
Resum: The OBJECTIVE of this study was to develop a way of evaluating pain levels among patients with advanced senile dementia who have no way of communicating. The method had to display adequate psychometric properties. The METHODS followed and the RESULTS obtained were as follows. There were four different phases in the process. PHASE 1. The items to be observed were selected by taking the opinion of clinical experts into account and by gathering together previous studies found in scientific literature. 24 items were proposed which were evaluated by 112 professionals from clinics who offered their opinion on whether or not the propositions were adequate in order to measure pain. PHASE 2. A pilot study was carried out in order to determine the validity of the 24 items when applied to 30 Alzheimer patients and 30 elderly people without cognitive deficiency whose dependency was moderate. Nine of the propositions were seen to possess higher psychometric properties. This scale displayed an internal consistency of 0. 77 once measured by Cronbach's Alpha coefficient; its validity, compared to the results of other scales for measuring pain, showed a significant correlation with the EVA (r=0. 44; p<0. 05), the Verbal Scale for Pain Intensity (r=0. 42; p<0. 05) and the MPQ-SV (r=0. 41; p<0. 05), for the group without cognitive deficiency; reliability between observers was deemed adequate given that there was an interclass correlation of between 0. 36 and 0. 96 (p<0. 05 to p<0. 001) for all the items and the different pairs of observers. PHASE 3. The evaluation of the behaviour of the Experimental Scale (9 items) was carried out on 126 people with advanced dementia. The exploratory and confirmatory factorial analyses were compatible for 8 of the items and three factors (Emotional Expression of Pain; Pain during care, and Spontaneous Pain Behaviour). Reliability (internal consistency), measured using Cronbach's Alpha coefficient, was 0. 66. Its concurrent validity, determined through the opinion of the professionals, showed that patients considered as 'no pain' by the professionals had significantly lower scores on the total scale as well as in the three factors of the scale. In order to determine the cut-off point of the scale, an analysis of the ROC curve was carried out and a value of 3 was found to be the indicator of the presence of pain. A user manual was developed, which was subject to the evaluation of the clinical professionals. Its use resulted in an interclass correlation of the same response for the same observation for different pairs of observers which ranged between 0. 51 y 0. 97 (p<0. 05 and p<0. 001). PHASE 4. A study was carried out in order to determine the sensitivity of the scale in cases of acute pain (blood test). This showed differences between the pain levels of the group who had had EMLA cream applied compared to the control group (p<0. 01). A second study of the sensitivity of the scale for cases of chronic pain (treatment of bedsores) was carried out. In this case, there was a significantly lower score (p<0. 05) for patients who had received subcutaneous morphine compared to the control group.
Nota: Bibliografia
Nota: Tesi doctoral - Universitat Autònoma de Barcelona. Facultat de Filosofia i Lletres, Departament de Psiquiatría i Medicina Legal, 2006
Nota: Consultable des del TDX
Nota: Títol obtingut de la portada digitalitzada
Drets: ADVERTIMENT. L'accés als continguts d'aquesta tesi doctoral i la seva utilització ha de respectar els drets de la persona autora. Pot ser utilitzada per a consulta o estudi personal, així com en activitats o materials d'investigació i docència en els termes establerts a l'art. 32 del Text Refós de la Llei de Propietat Intel·lectual (RDL 1/1996). Per altres utilitzacions es requereix l'autorització prèvia i expressa de la persona autora. En qualsevol cas, en la utilització dels seus continguts caldrà indicar de forma clara el nom i cognoms de la persona autora i el títol de la tesi doctoral. No s'autoritza la seva reproducció o altres formes d'explotació efectuades amb finalitats de lucre ni la seva comunicació pública des d'un lloc aliè al servei TDX. Tampoc s'autoritza la presentació del seu contingut en una finestra o marc aliè a TDX (framing). Aquesta reserva de drets afecta tant als continguts de la tesi com als seus resums i índexs.
Llengua: Castellà.
Document: Tesis i dissertacions electròniques ; doctoralThesis
Matèria: Demència senil ; Dolor en els vells ; Dolor ; Mesurament
ISBN: 8468999865

Adreça alternativa:: http://hdl.handle.net/10803/5569


316 p, 2.2 MB

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