Development and preliminary validation of the pain assessment checklist for seniors with limited ability to communicate (PACSLAC)

Pain Manag Nurs. 2004 Mar;5(1):37-49. doi: 10.1016/j.pmn.2003.10.001.


The purpose of this study, conducted in three phases, was to develop a clinically useful observational tool (i.e., the Pain Assessment Checklist for Seniors With Limited Ability to Communicate [PACSLAC]) to assess pain in seniors with severe dementia. In Phase 1, professional caregivers of seniors with severe dementia were interviewed in order to generate a list of pain-related behaviors that are characteristic of care recipients living in long-term-care facilities. Based on a systematic examination of interview transcripts by experienced researchers and an independent coder, a behavioral checklist (i.e., the initial version of the PACSLAC) was developed. The checklist items were organized into conceptually based subscales (e.g., facial expressions, activity/body movement). Phase 2 focused on an assessment of the internal consistency of the checklist (alpha =.92). Following an item analysis, the subscales of the PACSLAC (Social/Personality/Mood Indicators, Facial Expressions, Activity/Body Movement, and Physiological Indicators/Eating/Sleeping Changes/Vocal Behaviors) were found to be internally consistent. Phase 3 focused on a preliminary validation of the PACSLAC. Analyses suggest that the PACSLAC discriminated among pain events (during which there was a clear and recognizable cause for the patients' pain), events during which patients were experiencing nonpainful distress, and situations during which patients were calm.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Affect
  • Aged
  • Aged, 80 and over
  • Aggression
  • Attitude of Health Personnel
  • Communication Disorders / complications*
  • Dementia / complications*
  • Discriminant Analysis
  • Facial Expression
  • Female
  • Geriatric Assessment / methods*
  • Humans
  • Kinesics
  • Male
  • Middle Aged
  • Nursing Assessment / methods
  • Nursing Assessment / standards
  • Nursing Evaluation Research
  • Pain / complications
  • Pain / diagnosis*
  • Pain Measurement / methods*
  • Pain Measurement / standards
  • Psychometrics
  • Sensitivity and Specificity
  • Social Behavior
  • Surveys and Questionnaires
  • Verbal Behavior