Psychometric Evaluation of the MOBID Dementia Pain Scale in U.S. Nursing Homes.
Keela Herr, Justine S Sefcik, Moni Blazej Neradilek and 3 others
PMID 31085096WHAT IT FOUND
The MOBID pain scale accurately detects pain in US nursing home residents with advanced dementia, correlating strongly with expert clinician ratings.
It is reliable, takes 5-8 minutes, and works when administered by trained non-nurse staff.
Key findings
01The overall MOBID score showed significant positive correlations with expert clinician pain ratings for usual, worst, and current pain.
02The scale demonstrated good internal consistency reliability in this English-speaking US sample.
03Trained non-clinician research coordinators were able to administer the tool accurately, suggesting it can be used by staff other than nurses.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used trained research coordinators rather than licensed nurses to administer the MOBID, which differs from the tool's intended clinical use. Most participants had low pain intensity ratings, possibly because 83% were receiving acetaminophen, so the tool's performance in patients with severe unmanaged pain is less clear. Interrater reliability for the MOBID was not directly tested in this study. Some data for two items were missing and had to be statistically imputed.
The easy way to misread this
Do not assume the 'at rest' observation is a reliable indicator of pain in this population. The study found low correlation between rest scores and expert ratings, and removing this item did not significantly reduce the overall score's validity.