Title: Appendix B
Author: Dalen, A.H. van (PHEG)
Last saved by: ltachado
Company: LUMC

Additional file 3. Rating scales for pain that were used in the reported studies

Pain rating scale | Type of measurement | Reason for development | Studies (first author)
Rating of observations | | |

PAINAD

Pain Assessment in Advanced Dementia Scale (Warden 2003)

5-item scale (nonverbal behaviours) 
Each item rated on a 3-point scale (0-2)

Developed to provide a clinically relevant and easy to use pain assessment tool for individuals with advanced dementia

Leong 2007, Lin 2011

DS-DAT

Discomfort Scale-Dementia Alzheimer Type (Hurley 1992)

9-item scale (nonverbal behaviours)
Each item is measured for absence or presence of indicators of discomfort which, if present, are scored for frequency, duration and intensity·

Developed to measure discomfort in elders with dementia of the Alzheimer’s type·

Zieber 2005

Rating of pain based on interview or observation | |

GMPI

Geriatric Multidimensional Pain and Illness Inventory (Clifford 2005)

12-items in 3 subscales: pain and suffering (3), interference (5), emotional distress (4)
Each item rated on a 10-point scale

Designed to assess pain and its functional, social and emotional consequences, in residents in long term care

Cipher 2004/2006

PPQ | Proxy Pain Questionnaire (Fisher 2002) | 3 items: presence Y/N, frequency, and intensity of pain on 13-point scale | To assess pain in cognitively impaired older people | Norton 2010 (1 item)
PGC-PIS | Philadelphia Geriatric Centre–Pain Intensity Scale (Parmelee 1991) | “worst pain” item: highest level of pain experienced over preceding 4 weeks on a 5-point scale | | Gruber-Baldini 2005, Kunik 2005/Morgan 2012, Williams 2005

InterRAI LCTF

InterRAI instrument for Long-Term Care Facilities

Any type of pain or discomfort in 3 days before assessment, based on extensive evaluation
Items on pain frequency, and severity (0-4)

Tosato 2011

MDS

Minimum Data Set

Items: pain intensity and frequency
Each item rated on a 3-point scale (0-3)

Ahn 2013, Leonard 2006, Volicer 2009/2011

Self-report of pain* | | |

-
VDS
VRS

Non-verbal visual analogue scale
Verbal Descriptor Scale
Verbal Rating Scale

7-point scale
7-point scale, pain right now 
4-point scale, pain right now

Brummel-Smith 2002 
Shega 2005/2010
Torvik 2010

* Developed for self-report, but sometimes used in interview
References

	1 	Clifford, P.A. and Cipher, D.J., 2008. The Geriatric Mulitdimensional Pain and Illness Inventory : A New Instrument Assessing Pain and Illness in Long-Term Care. Clinical Gerontologist 28, 45-61.
	2 	Fisher, S.E., Burgio, L.D., Thorn, B.E., Allen-Burge, R., Gerstle, J., Roth, D.L., and Allen, S.J., 2002. Pain assessment and management in cognitively impaired nursing home residents: association of certified nursing assistant pain report, Minimum Data Set pain report, and analgesic medication use. J.Am.Geriatr.Soc. 50, 152-156.
	3 	Hurley, A.C., Volicer, B.J., Hanrahan, P.A., Houde, S., and Volicer, L., 1992. Assessment of discomfort in advanced Alzheimer patients. Res.Nurs.Health 15, 369-377.
	4 	Parmelee, P.A., Katz, I.R., and Lawton, M.P., 1991. The relation of pain to depression among institutionalized aged. J.Gerontol. 46, 15-21.
	5 	Warden, V., Hurley, A.C., and Volicer, L., 2003. Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) scale. J.Am.Med.Dir.Assoc. 4, 9-15.