Pain in dementia: A systematic review of the measurement properties of observational assessment tools

IF 11.2 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review Pub Date : 2026-03-01 Epub Date: 2026-01-20 DOI:10.1016/j.cpr.2026.102704

Andrew I.G. McLennan , Emily M. Winters , Michelle M. Gagnon , Thomas Hadjistavropoulos

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Abstract

We conducted a systematic review of the measurement properties and quality of evidence of observational pain assessment tools for older adults with dementia. Eligible studies were peer-reviewed, written in English, had a primary aim to psychometrically examine observational pain tools in samples of older adults with dementia, and reported results for at least one psychometric measurement property (e.g., reliability, structural validity, responsiveness). Medline, PsycINFO, the Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Web of Science were systematically searched for all historical records to September 2025. The review was pre-registered in PROSPERO in February 2025, and adhered to the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN), and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines for COSMIN systematic reviews (i.e., PRISMA-COSMIN) to evaluate and report the methodological quality, psychometric results, and strength of evidence for each tool. This standardized framework also guided our recommendations of tools based on psychometric merit. Thirty observational pain tools were identified across 121 psychometric studies, and five tools met criteria for a strong recommendation. Certain measurement properties (i.e., construct validity, responsiveness) showed stronger results and higher-quality evidence across tools, while others (e.g., structural validity, content validity) were understudied and showed inconsistent and lower-quality evidence. We summarized methodological limitations in the pre-existing literature and provided research recommendations to help direct future scholarly work in this area.

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痴呆中的疼痛：观察性评估工具测量特性的系统回顾

我们对老年痴呆患者观察性疼痛评估工具的测量特性和证据质量进行了系统回顾。符合条件的研究经过同行评审，以英文撰写，主要目的是对老年痴呆患者样本中的观察性疼痛工具进行心理测量学检验，并报告至少一项心理测量特性的结果（例如，信度、结构效度、反应性）。系统检索Medline、PsycINFO、护理与相关健康文献累积索引（CINAHL）和Web of Science，查找截至2025年9月的所有历史记录。该综述于2025年2月在PROSPERO预注册，并遵循基于共识的健康状况测量工具选择标准（COSMIN）和COSMIN系统评价和荟萃分析首选报告项目（PRISMA）报告指南（即PRISMA-COSMIN）来评估和报告每种工具的方学质量、心理测量结果和证据强度。这个标准化的框架也指导了我们基于心理测量价值的工具推荐。在121项心理测量研究中确定了30种观察性疼痛工具，其中5种工具符合强烈推荐标准。某些测量属性（例如，结构效度，响应性）显示出更强的结果和更高质量的证据，而其他测量属性（例如，结构效度，内容效度）研究不足，显示出不一致和低质量的证据。我们总结了现有文献中方法上的局限性，并提供了研究建议，以帮助指导该领域未来的学术工作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Psychology Review PSYCHOLOGY, CLINICAL-

CiteScore

23.10

自引率

1.60%

发文量

期刊介绍： Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology. While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.