Cross-cultural adaptation and psychometric validation of the Turkish version of Abbey Pain Scale in dementia patients
Sevilay Erden
, İlknur Tura, Pınar Kaya, Songül Karadağ
Department of Nursing, Çukurova University, Faculty of Health Sciences, Adana, Türkiye
Keywords: Abbey Pain Scale, dementia, intensive care, pain assessment, reliability, validity.
Abstract
Background: The aim of this study was to culturally adapt the Abbey Pain Scale (APS-TR) into Turkish and to evaluate the validity and reliability of the scale in dementia patients.
Patients and Methods: Between September 16, 2020 and April 16, 2023, a total of 103 dementia patients aged ≥ 65 who were admitted to the intensive care units of a university hospital were included in the study. Pain levels were assessed 1 min before mobilization or repositioning, during the procedure, and 20 min afterward using the Turkish version of the APS, the Nonverbal Pain Scale (NVPS), and the Verbal Descriptive Scale (VDS). Construct validity was evaluated through exploratory and confirmatory factor analyses. Reliability was assessed using internal consistency analysis with Cronbach’s alpha coefficient, and criterion validity was examined by analyzing correlations between APS-TR and the other pain scales using Pearson correlation analysis.
Results: Of a total of 103 patients, 37 were male and 66 were female with a mean age of 71.7 ± 5.67 (range, 65 to 92) years. As a result of linguistic and cultural adaptation, the Turkish version of the scale was found to be appropriate. The content validity index was found to be 0.90. Exploratory factor analysis showed that the items formed a single-factor structure, and factor loadings ranged from 0.489 to 0.855. Confirmatory factor analysis fit indices (χ2/df = 1.21, root mean square error of approximation [RMSEA] = 0.046, standardized root mean square residual [SRMR] = 0.045, [comparative fit index] = 0.989) indicated that the model was acceptable. The Cronbach's alpha coefficient of the scale was calculated as 0.777, and positive and significant relationships were found between APS-TR and NVPS and VDS at all measurement times.
Conclusion: Our study results suggest that the Turkish version of the APS is a valid, reliable, and unidimensional measurement instrument which can be used to assess pain in dementia patients receiving treatment in intensive care.
Cite this article as: Erden S, Tura İ, Kaya P, Karadağ S. Cross-cultural adaptation and psychometric validation of the Turkish version of Abbey Pain Scale in dementia patients. Agri 2026;38(4):257-263. doi: 10.5606/agri.2026.97.