Gerontological Nursing Interventions Research Center (GNIRC)

Title: Pain Assessment in Minority Older Adults with Dementia
Principal Investigator: Sheila Decker, PhD, RN
Study Site: University of Iowa

Abstract
Disparities exist in pain assessment and management of institutionalized older adults with dementia, with minority older adults at risk for not receiving pain medications. Cultural attitudes influence an older adult's pain experinece, yet knowledge is lacking about how cultural attitudes influence pain experiences in minority older adults with dementia. Although pain assessment instruments exist to assess pain in older adults with dementia, these instruments have limited psychometrics. Furthermore, reliability and validity have not been established for these instruments in minority older adults with dementia. The purposes of this pilot study are to test a pain assessment instrument with nonverbal cues that reflect pain experiences of institutionalized minority older adults with dementia and to test a cognitive function instrument. The specific aims are to establish reliability and validity for the pain assessment instrument, and to establish reliability for the Clinical Dementia Rating Scale. A sample of expert nurses in pain with minorities, 10 for African-Americans and 10 for Latinos, will establish content validity for nonverbal pain cues identified from the research literature. Institutionalized older adults with dementia, 20 African-Americans and 20 Latinos, will be assessed for pain using the nonverbal cues identified by the expert nurses. The cognitive function tests will be administered at the time of enrollment into the study. Data analysis will include descriptive statistics, interrater and tes-retest reliability, and independent t-tests. The findings from this pilot will provide instruments for further testing that are culturally sensitive for selected populations.