Psychometric Evaluation of the MOBID Dementia Pain Scale in U.S. Nursing Homes.

Abstract

PURPOSE\nThe Mobilization-Observation-Behavior-Intensity-Dementia (MOBID) Pain Scale is an observational tool in which raters estimate pain intensity on a 0-10 scale following five standardized movements. The tool has been shown to be valid and reliable in northern European samples and could be useful in the United States (US) for research and clinical purposes. The goal of this study was to examine the validity and reliability of the MOBID among English-speaking nursing home residents in the US.\n\n\nDESIGN\nCross-sectional study.\n\n\nSETTINGS\nSixteen nursing homes in Pennsylvania, New Jersey, Georgia and Alabama.\n\n\nPARTICIPANTS\nOne hundred thirty-eight older adults with dementia and moderate to severe cognitive impairment.\n\n\nMETHODS\nValidity was evaluated using Spearman correlations between the MOBID overall pain intensity score and 1) an expert clinician s pain intensity rating (ECPIR), 2) nursing staff surrogate pain intensity ratings, and 3) known correlates of pain. We assessed internal consistency by Cronbach s alpha.\n\n\nRESULTS\nMOBID overall scores were significantly associated with expert clinician s rating of current and worst pain in the past week (rho = 0.54, and 0.57; p < .001, respectively). Statistically significant associations also were found between the MOBID overall score and nursing staff current and worst pain intensity ratings as well as the Cornell Scale for Depression in Dementia (rho = 0.29; p < .001). Internal consistency was acceptable (α = 0.83).\n\n\nCONCLUSIONS AND CLINICAL IMPLICATIONS\nResult of this study support the use of the MOBID in English-speaking staff and residents in the US. Findings also suggest that the tool can be completed by trained, nonclinical staff.