Abstract
Accurate pain assessment is essential for the effective pain management of geriatric patients. This study evaluated the concurrent validity of the Pain Assessment in Advanced Dementia-Thai version (PAINAD-Th), against self-reported pain in postoperative geriatric patients. Additionally, we examined the utility of the PAINAD-Th for assessing pain response to analgesic intervention. This descriptive correlational design study was conducted at a Thai tertiary care hospital. A total of 208 geriatric patients underwent cognitive function assessment via the Thai Mental State Examination (TMSE). Self-reported pain scores (using the verbal descriptor scale [VDS] and Numerical Rating Scale [NRS]) and PAINAD-Th scores were recorded in the postanesthetic care unit and on the first postoperative day in the ward. The data analysis focused on the concurrent validity of self-report pain scales and the PAINAD-Th, and the latter's sensitivity in detecting pain reduction following analgesic treatment. The mean patient age was 77.6 years, and the mean TMSE score was 23.9. A strong correlation existed between the VDS and the PAINAD-Th scores in both cognitively impaired and cognitively intact patients (0.876 and 0.696, respectively; p < 0.001). The NRS and PAINAD-Th scores were moderately correlated in patients with mild to moderate cognitive impairment and intact cognition (0.58 and 0.63, respectively; p < 0.001). Importantly, both the PAINAD-Th and NRS scores decreased significantly following analgesic administration. The PAINAD-Th is a useful alternative pain assessment tool for the postoperative pain management of geriatric patients. This holds true for both cognitively impaired and intact patients who may struggle to provide self-reported pain scores.