The Usability of the Abbey Scale in Caregivers’ Pain Assessment of Hospice Patients without Ability to Self-Report

Abstract

Background: Evidence has shown that one of the main concerns of family caregivers of hospice patients with limitations in verbalization was with their own ability to recognize whether their loved one was in pain and how severe was their pain. Purpose: The purpose of the project was to evaluate the usefulness of the Abbey pain scale in the assessment of pain in adult patients who cannot express or describe pain by family caregivers. Methods: This project followed a descriptive study design. The participants were family caregivers of patients who received services from a hospice agency in Phoenix, Arizona, and who had limitations in verbalization. The intervention was delivered in the family home. After the participants who agreed to be trained in the use of the Abbey scale had the opportunity to be familiarized with the scale for two weeks they were asked to complete a paper-format 16-item survey composed of demographic, Likert-style, and open-ended questions regarding their experience with the scale. They were also asked to turn in the record sheets they had used to enter the pain assessment scores obtained and the interventions provided to patients as a result. Due to the small number of participants, data analysis focused on describing and comparing answers between the completed surveys. The answers to the open-ended question were subjected to theme extraction. The score and intervention records were analyzed for trends in Abbey scale use. Results: Out of the three participants who agreed to be trained in the use of the Abbey scale, only two (67%) returned the completed questionnaires and score and intervention records. One of the participants agreed that the Abbey scale was useful in helping recognize pain in their loved one, while the other disagreed. However, both participants agreed that the scale helped them determine the severity of the pain. Trends in the use of the scale revealed that participants provided interventions for every score higher than 0 on the Abbey scale. Analysis of short answers showed that personal health factors may play a role in caregivers’ interactions with the Abbey scale. Implications: Although the results showed promising value of the Abbey scale in helping family caregivers determine the severity of pain in their loved ones, limitations in number of participants in this study invite further investigation into this issue on a larger scale. Further study of ways to counteract personal health challenges in caregivers related to pain assessment may also be beneficial.