Cultural adaptation and reproducibility validation of the Brazilian Portuguese version of the Pain Assessment in Advanced Dementia (PAINAD-Brazil) scale in non-verbal adult patients

Objective To adapt the Pain Assessment in Advanced Dementia (PAINAD) scale to Brazilian Portuguese with respect to semantic equivalence and cultural aspects, and to evaluate the respective psychometric properties (validity, feasibility, clinical utility and inter-rater agreement). Methods Two-stage descriptive, cross-sectional retrospective study involving cultural and semantic validation of the Brazilian Portuguese version of the scale, and investigation of its psychometric properties (validity, reliability and clinical utility). The sample consisted of 63 inpatients presenting with neurological deficits and unable to self-report pain. Results Semantic and cultural validation of the PAINAD scale was easily achieved. The scale indicators most commonly used by nurses to assess pain were “Facial expression”, “Body language” and “Consolability”. The Brazilian Portuguese version of the scale has proved to be valid and accurate; good levels of inter-rater agreement assured reproducibility. Conclusion The scale has proved to be useful in daily routine care of hospitalized adult and elderly patients in a variety of clinical settings. Short application time, ease of use, clear instructions and the simplicity of training required for application were emphasized. However, interpretation of facial expression and consolability should be given special attention during pain assessment training.

研究目的：针对语义等效性与文化适配性，将晚期痴呆疼痛评估量表（Pain Assessment in Advanced Dementia, PAINAD）适配为巴西葡萄牙语版本，并评估其对应的心理测量学属性（效度、可行性、临床实用性及评定者间一致性）。
研究方法：本研究为两阶段描述性横断面回顾性研究，涵盖该量表巴西葡萄牙语版本的文化与语义效度验证，以及其心理测量学属性（效度、信度及临床实用性）的考察。研究样本纳入63名存在神经功能缺损且无法自我报告疼痛的住院患者。
研究结果：PAINAD量表的语义与文化适配验证顺利完成。护士评估疼痛时最常用的量表指标为「面部表情」「肢体动作」与「可安抚性」。该量表的巴西葡萄牙语版本已被证实具备效度与准确性；良好的评定者间一致性水平保障了结果可重复性。
研究结论：该量表已被证实可应用于多种临床场景下住院成人与老年患者的日常护理工作。研究强调了其应用耗时短、操作简便、指导说明清晰以及培训门槛低等优势。但在疼痛评估培训过程中，需重点关注面部表情解读与可安抚性判断环节。