Traducción al castellano y validación de la escala Abbey para la detección del dolor en pacientes no comunicativos

摘要

Objective: The validation of a pain assessment scale for non communicative Spanish patients: Spanish version of the Abbey scale. Patients and methods: Geriatric unit in the hospital setting included all non-communicative patients over 60 years, with the exclusion of those who had respiratory failure, cerebral coma, severe brain trauma, or taking palliative oncological treatment. Variables: age, sex, carer, reason for admission, diagnosis, treatment, scale scores. Patients were evaluated using the Abbey scale for the detection of pain, Mini-Mental for evaluation of cognitive impairment, and the Global Deterioration Scale. When pain was detected it was treated with round the clock analgesics, and the patient was evaluated at 24 hour intervals, until pain was controlled, scale scores were noted each time. Statistical Analyses: Descriptive study of the variables tested. Psychometric properties: Reliability: Intrarater (ICC- intraclass correlation coefficient), Inter-rater (Kappa) and the internal consistency of the scale was measured using α-Cronbach. Validity: predictive validity was measured using ROC curve analysis, concurrent validity (Spearman) and sensitivity to change (Wilcoxon). Results: Data was collected from 119 non communicative patients; 71 (59.7%) women, mean age 81.62 ± 0.716. Pain was detected in 44 patients (37.8%). Reliability: ICC (intrarater) = 0.77; kappa (inter-rater) = 0.65 and α-cronbach (internal consistency) = 0.71. Validity: concurrent validity with the holistic impression of the examiner Pearson coefficient (r = 0.82, p = 0.001). Predictive Validity (ROC curve analysis) for a cut off score of 3; Specifity 100% and sensitivity 95.6% (Youden's Index 0.96). Sensitivity to change was of statistical significance Z = 5.35. Conclusions: Although results were moderate, findings show evidence of reliability and validity of the Spanish version of the Abbey scale.