The Rotterdam Elderly Pain Observation Scale (REPOS): A new behavioral pain scale for non-communicative adults and cognitively impaired elderly persons

Rhodee Van Herk, Monique Van Dijk*, Dick Tibboel, Frans P.M. Baar, Rianne De Wit, Hugo J. Duivenvoorden

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

27 Citations (Scopus)
4 Downloads (Pure)

Abstract

Several observation scales have been developed to measure pain in elderly persons with cognitive impairments. Most scales, however, do not provide cut-off scores for pain, and previous studies do not include data on non-verbal patients with diagnoses other than dementia. Objective: The development of an easy-to-use, reliable and valid pain observation scale, the Rotterdam Elderly Pain Observation Scale (REPOS), for use in nursing home residents incapable of reporting pain themselves. Methods: In this multicenter case-control study 174 residents of various cognitive levels were videotaped at rest and during a potentially painful activity. Prevalences and co- occurrences of behaviors were examined, and interrelationships were identified. To reduce number of items, multiple linear regression analysis was used. Interrater-, and intrarater agreements and internal consistency were investigated. To estimate validity, REPOS was related to Numeric Rating Scale (NRS) and Pain Assessment in Advanced Dementia-Scale (PAINAD), and activity and rest situations were compared. Results: A one-dimensional model with a good fit was found. After redundancy analysis, ten items remained. Interrater- and intrarater agreements of two observers were good. Internal consistency was moderate. Correlations between REPOS and NRS were small to medium, and between REPOS and PAINAD large. REPOS-scores for the two situations differed significantly. A total score of 3 and higher indicates pain. Conclusions: REPOS appears to be promising for identifying pain in residents of various cognitive levels. To improve pain management, a cut-off score for pain was determined, together with a treatment protocol. Its conciseness suggests good usefulness in daily practice.

Original languageEnglish
Pages (from-to)367-378
Number of pages12
JournalJournal of Pain Management
Volume1
Issue number4
Publication statusPublished - Jan 2009

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