Assessing pain through behavioural observation

Wade, Kelly Anne (2019). Assessing pain through behavioural observation. University of Birmingham. Clin.Psy.D.

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Background: The health inequalities faced by people with intellectual disabilities (ID) are well documented, affecting both duration and quality of life. Painful health conditions can be difficult to recognise as many people with ID struggle to self-report their pain. Therefore it is important that accurate observational tools are available to support recognition and assessment of pain in people with ID.
Aim: This thesis seeks to assess the use of currently available observational assessments of pain through meta-analytic methods, and then evaluates a more specialist observational tool designed to detect gastric pain.
Meta-analysis: A comprehensive review of the literature found 62 distinct observational measures used in published research. The five most commonly used measures were assessed through a series of meta-analyses, synthesising correlations between observational and self-report measures of pain. Moderate correlations were found for all observational measures compared to self-report, though unacceptable levels of heterogeneity were also identified. Recommendations are made for use of the Face, Legs, Activity, Crying, Consolability scale.
Empirical paper: The Gastric Distress Questionnaire (GDQ) is a parent report measure designed to screen for Gastro-oesophageal Reflux Disease (GORD), a painful health condition which is common in people with ID. Significant differences in GDQ scores were found between children with and without recent GORD. A clinical cut off is recommended for the use of the GDQ to screen for reflux. Behavioural observation by a naïve observer was not found to associate to GDQ scores provided by a parent, emphasising the importance of caregiver report in identifying GORD.

Type of Work: Thesis (Doctorates > Clin.Psy.D.)
Award Type: Doctorates > Clin.Psy.D.
Licence: All rights reserved
College/Faculty: Colleges (2008 onwards) > College of Life & Environmental Sciences
School or Department: School of Psychology, Department of Clinical Psychology
Funders: None/not applicable
Subjects: B Philosophy. Psychology. Religion > BF Psychology


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