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Table 8 Pain assessment by observer ratings in PAIC tool: Vocalisation items*

From: An international road map to improve pain assessment in people with impaired cognition: the development of the Pain Assessment in Impaired Cognition (PAIC) meta-tool

VOCALIZATION

MEANING OF ITEMS

Not at all

Slight degree

Moderate degree

Great degree

Not scored

a = Item is not clear

b = Situation is unsuitable

c = Physical status of person not suitable for scoring

d = Other

Using offensive words a

Cursing, swearing, or using foul language

0

1

2

3

a b c d

Using pain-related words a

Using pain words, like “ouch”, “ow”, or “that hurts”

0

1

2

3

a b c d

Repeating words a

Repeating words or phrases again and again (not stuttering)

0

1

2

3

a b c d

Complaining a

Expressing being unhappy, sick, uncomfortable, and/or in pain

0

1

2

3

a b c d

Shouting a

Using a loud voice to express words

0

1

2

3

a b c d

Mumbling a

Uttering words and/or sounds indistinctly

0

1

2

3

a b c d

Screaming b

Using a loud and/or high-pitched voice to express sounds

0

1

2

3

a b c d

Groaning b

Making a deep, inarticulate sound

0

1

2

3

a b c d

Crying b

Whimpering, sobbing, wailing, or weeping

0

1

2

3

a b c d

Gasping c

Breathing sharply, laboriously, and/or loudly

0

1

2

3

a b c d

Sighing c

Taking in and letting out a long, loud breath

0

1

2

3

a b c d

  1. *Instructions for users: Please record each vocalisation described in the table below. Rate the intensity of each item from ‘not at all’ to ‘a great degree’. If an item is not scored please indicate why not.
  2. Subcategory: averbal utterances, bnonverbal utterances and cbreaths.