Table 1.

Characteristics of the pain assessment tools useful for non-communicative patients with severe dementia and intubated.

Pain assessment tool	Authors and year of first publication	Type of scale	Number of items	Time of execution	Qualification of rater	Validity and reliability
Mobilization–Observation–Behavior–Intensity–Dementia (MOBID)-2.	(35)	Observational scale.	It consists of two parts of 5 items each. Part 1: assessment of musculoskeletal pain observing pain behavior during the execution of five guided movements. Part II: assessment of pain from internal organs, head and skin pain behavioral indicators, and localization of pain crossing on pain drawing.	Time-efficient in use (mean 4.37 min, range 2.0–7.0).	Trained nurse.	Moderate to excellent agreement was demonstrated for behaviors and pain drawings (κ = 0.41–0.90 and κ = 0.46–0.93). Inter-rater and test–retest reliability for pain intensity: ICC 0.80–0.94 and 0.60–0.94. Internal consistency: Cronbach's α ranging 0.82–0.84. Good face-, construct- and concurrent validity. Correlation of overall pain intensity with physicians' clinical examination and defined pain variables (rho = 0.41–0.64).
Critical-Care Pain Observation Tool (CPOT).	(39)	Observer rated scale.	It consists of 4 items: facial expression, body movement, ventilator compliance, and muscle tension.	The patient is observed for 1 min at rest and during and after nociceptive procedure.	Trained nurse.	Inter-rater reliability: k = 0.52–0.88. Acceptable reliability and validity, with significant discriminant validity (paired t-tests, P ≤ 0.001). Criterion validity: analyses of variance ANOVA (P ≤ 0.001) and Spearman correlations (0.40–0.59, P ≤ 0.001).