Abbey Pain Scale: Development and validation of the Japanese version


Ms Yukari Takai, MHS, Grad Dip AN, RN, Department of Gerontological Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8591, Japan. Email:


Aim:  The purpose of this study was to develop and validate the Japanese version of the Abbey Pain Scale (APS-J), to assess pain of older adults who live in nursing homes in Japan.

Methods:  In this study, the data were collected from residents in two nursing homes in Japan to include: demographics, the Barthel Index, Folstein Mini-Mental Examination (MMSE), APS-J and Verbal Descriptor Scale (VDS) for pain. Two researchers independently assessed the residents' pain using the APS-J while the residents walked or were transferred from bed to wheelchair. Intraclass correlation coefficients (ICC) for inter-rater and test–retest reliability, Chronbach's α-value of the APS-J, and correlation between the APS-J and other variables were examined.

Results:  Data were obtained from 171 residents. The ICC for inter-rater and test–retest reliability were 0.824 and 0.657, respectively. Internal consistency was 0.645 for the total sample and 0.719 for those with an MMSE score of 0 (n = 58). Multiple regression analysis showed that contractures (P < 0.001), previous injuries (P < 0.001), the MMSE (P = 0.003) and paralysis (P = 0.018) were independently associated with the APS-J. The APS-J and VDS were moderately correlated (r = 0.49; P < 0.01). The APS-J total score and subscales, “change in body language” and “physical changes”, were significantly different among subjects with different MMSE score groups.

Conclusion:  Findings show some evidence for the reliability and validity of APS-J.