Psychometric evaluation of the Orofacial Pain Scale for Non‐Verbal Individuals as a screening tool for orofacial pain in people with dementia |
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| Authors: | Suzanne Delwel Andrea B. Maier Cees M. P. M. Hertogh Henrica C. W. de Vet Frank Lobbezoo Erik J. A. Scherder |
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| Affiliation: | 1. Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands;2. Department of Clinical Neuropsychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands;3. Department of Medicine and Aged Care, The Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia;4. Department of Human Movement Sciences, MOVE Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands;5. Department of Elderly Care Medicine, Faculty of Medicine, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands;6. Department of Epidemiology and Biostatistics and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands |
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| Abstract: | Objective The aim of this study was to describe the psychometric evaluation of the Orofacial Pain Scale for Non‐Verbal Individuals (OPS‐NVI) as a screening tool for orofacial pain in people with dementia. Background The OPS‐NVI has recently been developed and needs psychometric evaluation for clinical use in people with dementia. The pain self‐report is imperative as a reference standard and can be provided by people with mild‐to‐moderate cognitive impairment. Methods The presence of orofacial pain during rest, drinking, chewing and oral hygiene care was observed in people with mild cognitive impairment (MCI) and dementia using the OPS‐NVI. Participants who were considered to present a reliable self‐report were asked about pain presence, and in all participants, the oral health was examined by a dentist for the presence of potential painful conditions. After item‐reduction, inter‐rater reliability and criterion validity were determined. Results The presence of orofacial pain in this population was low (0%‐10%), resulting in an average Positive Agreement of 0%‐100%, an average Negative Agreement of 77%‐100%, a sensitivity of 0%‐100% and a specificity of 66%‐100% for the individual items of the OPS‐NVI. At the same time, the presence of oral problems, such as ulcers, tooth root remnants and caries was high (64.5%). Conclusion The orofacial pain presence in this MCI and dementia population was low, resulting in low scores for average Positive Agreement and sensitivity and high scores for average Negative Agreement and specificity. Therefore, the OPS‐NVI in its current form cannot be recommended as a screening tool for orofacial pain in people with MCI and dementia. However, the inter‐rater reliability and criterion validity of the individual items in this study provide more insight for the further adjustment of the OPS‐NVI for diagnostic use. Notably, oral health problems were frequently present, although no pain was reported or observed, indicating that oral health problems cannot be used as a new reference standard for orofacial pain, and a regular oral examination by care providers and oral hygiene care professionals remains indispensable. |
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| Keywords: | cognitive impairment dementia dentistry orofacial pain pain assessment |
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