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Objective. The goal of this study was to conduct initial psychometric analyses of a seven-item pain intensity measure for persons with dementia (PIMD) that was developed using items from existing pain observational measures. Design and Methods. We evaluated validity by examining associations with an expert clinician’s pain intensity rating (ECPIR) and an established pain observation tool (Mobilization Observation Behaviour Intensity Dementia [MOBID]). We also examined correlations between the PIMD and known correlates of pain: depression, sleep disturbances, agitation, painful diagnoses, and caregiver pain reports. We examined the differences between PIMD scores for “at rest” and “during movement” observations. We assessed reliability by calculating Cronbach’s alpha and estimating inter-rater reliability using intraclass correlations (ICCs). Finally, we examined whether six additional “recent changes in behavior” items improved the PIMD’s ability to predict expert clinicians’ pain ratings. Setting. Sixteen nursing homes located in Alabama, Georgia, Pennsylvania, and New Jersey. Participants. One hundred ninety residents with moderate to severe cognitive impairment, mean age of 84 years, 49.5% female, and 70% white. Results. PIMD during movement scores were highly correlated with the ECPIR and overall MOBID scores. As expected, there were large differences between at rest and during movement PIMD scores. Associations of PIMD with known correlates of pain were generally low and statistically nonsignificant. Internal consistency was supported with a Cronbach alpha of 0.72 and an inter-rater ICC of 0.82 for during movement PIMD scores. Conclusions. Initial evaluation of the PIMD supports its validity and reliability. Additional testing is needed to evaluate the tool’s sensitivity to changes in pain intensity. [ABSTRACT FROM AUTHOR]

Purpose: The 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., Design: Cross-sectional study., Settings: Sixteen nursing homes in Pennsylvania, New Jersey, Georgia and Alabama., Participants: One hundred thirty-eight older adults with dementia and moderate to severe cognitive impairment., Methods: Validity 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., Results: MOBID 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)., Conclusions and Clinical Implications: Result 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., (Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)