Application of the Abbey Pain Scale for Assessment of Acute Perioperative Pain in Elderly Patients with Impaired Communication Following a Femur Fracture

Marica Jerleković, Marina Domijan, Saša Bareta, Luka Djulabić, Vlatko Mičković, Zoran Lončar


Pain resulting from physical trauma and surgical procedures is very strong. In elderly patients, especially those with
impaired communication or cognitive damage, it is assessed rarely or not at all. The importance of pain assessment is
reflected in quality supervision and adequate treatment which decrease complications and speed up recovery. The aim of
the study was to determine the metric characteristics (reliability and validity) of the Abbey Pain Scale on a population of
elderly patients with impaired communication in Croatia and to demonstrate the correlation between the assessed acute
pain level and analgesia efficacy. The sample consisted of 31 patients above the age of 65 hospitalized after a femur fracture
at the Department of Traumatology, Sestre Milosrdnice University hospital, Zagreb, Croatia. The Abbey Pain Scale
and Visual Analogue Scale were used for pain assessment. The patients’ mental status was evaluated using Mini-Mental
State Examination. The data was processed using Chi-squared and Cronbach’s alpha tests, and small dependent samples
were tested using T-test. The value of Cronbach’s alpha coefficient of 0.561 for the Abbey Pain Scale was considered acceptable.
The score on the Abbey Pain Scale correlates significantly with the result of a standardized self-assessment of
pain intensity (r = 0.739, p= 0.001). We conclude that the Abbey Pain Scale serves as a convenient tool for assessing pain
intensity in patients with impaired communication, and its use is indirectly related to satisfactory analgesia, due to good
metric characteristics of validity and reliability.


femur fracture, pain assessment, elderly, impaired communication, Abbey Pain Scale

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