Comparing The Abbey And PAINAD Scales

As both The Abbey and PAINAD scales are subjective tools, where assessment is something that is based on personal opinion or knowledge, the lack of training and guidance provided could cause results to be interpreted differently depending on who was undertaking the assessment (Buffum et al., 2007). It was recognised that results were also dependent on prior knowledge of the individual themselves. A clinical study undertaken by Helfand and Freeman (2009) suggested that nursing staff involved in the study found that both PAINAD and Abbey pain scales required prior knowledge of the individual. When staff undertook the assessments within an acute clinical setting it was difficult to ascertain and interpret whether a patient with dementia had pain, if they were
displaying normal behaviour(s) or were acutely confused and symptomatic due to change of environment and felt that the lack of family involvement effected the results. (Helfand and Freeman, 2009) Those in the study felt that knowledge and involvement from family or caregivers of the individual should be considered. This included involvement during pain assessment selection processes and to aid staff with recognition of pain for those with communication difficulties and for patients with late stage dementia (Williamson et al., 2012). Nurses found that involving family and caregivers in non-verbal pain assessments such as PAINAD and The Abbey Scale, helped to enhance the effectiveness and management of pain in an acute setting (Coker et al, 2008). Family and caregiver involvement helped to build and enhance communication between the patient, the nursing team and family members with significant improvements of care for those with dementia (Cunningham, 2006).
Both scales positively enhanced nursing care in an acute setting and were both as equally valuable in assessing pain for patients with dementia (Bird, 2005). When evaluating and comparing one against the other, it was felt that both scales enabled pain assessment for dementia/cognitively impaired older people to be more individualised and person centred. However it was found that The Abbey Pain Scale was the preferred choice but it did require the assessor to be trained to use it and was formatted with nurses and doctors when being produced (Abbey, 2004). The PAINAD scale was found to be confusing due to the vocabulary used, but with the needed adjustments of breathing pattern vocabulary, it would be as highly credited as The Abbey Scale (Coker, E. et al, 2008). PAINAD did help educate family and caregivers to understand what were pain associated signals easier enabling recognition of which behaviours to look out for and how to compare what was normal to what was a sign of pain (McClean W,
2007). The PAINAD scale was favoured by family and caregivers as it did not require training to be used and was most appropriate for lay people (Krulewitch et al, 2008).