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Construct Validity of an Adult Pain Observation Scale for People with Profound Intellectual and Multiple Disabilities: The APOS-PIMD

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Title: Construct Validity of an Adult Pain Observation Scale for People with Profound Intellectual and Multiple Disabilities: The APOS-PIMD
Language: English
Authors: Annemieke Enninga (ORCID 0000-0002-1199-9943), Wendy J. Post (ORCID 0000-0002-4290-6287), Aly Waninge (ORCID 0000-0002-2316-2577), Annette A. J. van der Putten (ORCID 0000-0003-4226-8147)
Source: Journal of Intellectual & Developmental Disability. 2026 51(1):83-92.
Availability: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 10
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Descriptors: Adults, Pain, Severe Intellectual Disability, Multiple Disabilities, Measures (Individuals), Observation, Test Validity, Test Reliability, Behavior, Foreign Countries
Geographic Terms: Netherlands
DOI: 10.3109/13668250.2025.2531706
ISSN: 1366-8250
1469-9532
Abstract: Background: Objective assessment of pain-related behaviours is crucial in adults with profound intellectual and multiple disabilities. No standardised pain observation instrument that specifically focuses on this target group is currently available. A previous study identified 12 pain-related behaviours in these persons. This study aimed to develop a valid and reliable instrument based on these 12 pain-related behaviours to assess pain in these adults in daily situations. Method: Videos of 91 adults with profound intellectual and multiple disabilities in potentially painful daily situations were scored using the 12 pain-related behaviour items. Mokken scale analysis was used to determine the construct validity of these items. Results: Analysis resulted in a 9-item scale (H = 0.46, Rho = 0.70), which appeared to be sample independent for the variables of sex, age and level of motor functioning. Conclusion: A scale containing 9 items (APOS-PIMD) with reasonable construct validity and sufficient reliability was developed, which can be used to measure pain in adults with profound intellectual and multiple disabilities in daily situations.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1505283
Database: ERIC
FullText Text:
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  Data: Construct Validity of an Adult Pain Observation Scale for People with Profound Intellectual and Multiple Disabilities: The APOS-PIMD
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  Data: <searchLink fieldCode="AR" term="%22Annemieke+Enninga%22">Annemieke Enninga</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-1199-9943">0000-0002-1199-9943</externalLink>)<br /><searchLink fieldCode="AR" term="%22Wendy+J%2E+Post%22">Wendy J. Post</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-4290-6287">0000-0002-4290-6287</externalLink>)<br /><searchLink fieldCode="AR" term="%22Aly+Waninge%22">Aly Waninge</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-2316-2577">0000-0002-2316-2577</externalLink>)<br /><searchLink fieldCode="AR" term="%22Annette+A%2E+J%2E+van+der+Putten%22">Annette A. J. van der Putten</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-4226-8147">0000-0003-4226-8147</externalLink>)
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Intellectual+%26+Developmental+Disability%22"><i>Journal of Intellectual & Developmental Disability</i></searchLink>. 2026 51(1):83-92.
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  Data: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
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  Data: <searchLink fieldCode="DE" term="%22Netherlands%22">Netherlands</searchLink>
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  Data: 10.3109/13668250.2025.2531706
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  Data: 1366-8250<br />1469-9532
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Objective assessment of pain-related behaviours is crucial in adults with profound intellectual and multiple disabilities. No standardised pain observation instrument that specifically focuses on this target group is currently available. A previous study identified 12 pain-related behaviours in these persons. This study aimed to develop a valid and reliable instrument based on these 12 pain-related behaviours to assess pain in these adults in daily situations. Method: Videos of 91 adults with profound intellectual and multiple disabilities in potentially painful daily situations were scored using the 12 pain-related behaviour items. Mokken scale analysis was used to determine the construct validity of these items. Results: Analysis resulted in a 9-item scale (H = 0.46, Rho = 0.70), which appeared to be sample independent for the variables of sex, age and level of motor functioning. Conclusion: A scale containing 9 items (APOS-PIMD) with reasonable construct validity and sufficient reliability was developed, which can be used to measure pain in adults with profound intellectual and multiple disabilities in daily situations.
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