The evaluation of two methods of measuring pain expression in individuals with mental retardation and developmental disabilities
by Shinde, Satomi Kimura, Ph.D., UNIVERSITY OF MINNESOTA, 2008, 112 pages; 3313468

Abstract:

Assessment of nonverbal behavioral expression of pain is intended to be useful for assessing and measuring pain for individuals with MR/DD who often have difficulty verbalizing their pain appropriately. The purpose of this study was to evaluate and compare two different pain assessment tools (Facial Action Coding System [FACS] and Pain and Discomfort Scales [PADS]) during a standardized sham controlled, blinded sensory testing to test (1) whether FACS and PADS were sensitive to sensory stimuli, (2) whether FACS and PADS were modality specific to different noxious and non-noxious (i.e. tactile) sensory stimuli, and (3) the degree of concordance between FACS and PADS. A sample of 44 participants with moderate to severe/profound MR/DD received a set of 10 trials consisting of 5 active stimuli (noxious and tactile) and 5 sham procedures in random orders. Each trial consisted of three time segments (baseline, stimulus, and recovery). The data collected include frequencies of facial action units (FAUs) coded by certified FACS coders, PADS item scores, and frequencies of head-specific gross motor behavior. FACS and PADS were both sensitive to time segments with significant increase from the baseline to the stimulus segments (p < .05, p = 0 respectively). Both the mean FAU frequency and PADS score during active stimulation were significantly greater than during sham (p = .06, p = .02 respectively). There were significant interaction effects for active vs. sham and the time segments for FACS ( p < .05) and PADS (p = 0). There were moderate correlations between the total FAU frequencies in FACS and PADS scores ( r = .41 to 51). There were significant group effects for gender both in FACS (p = 0) and PADS (p = 0) with females' FACS FAU frequency and PADS scores both significantly higher than males'. There were significant effects for the presence/absence of self-injurious behavior (SIB) in FACS (p = 0) and PADS (p = 0) with SIB group significantly higher than no SIB group. The results support sensitivity of FACS and PADS. Replication of this study with different stimulus modalities and other recommendations are discussed.

 
AdviserFrank J. Symons
SchoolUNIVERSITY OF MINNESOTA
SourceDAI/B 69-05, p. , Aug 2008
Source TypeDissertation
SubjectsMental health; Special education; Clinical psychology; Medical Biophysics
Publication Number3313468
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