Dr. Roberta DiDonato
Department of Psychology, Faculty of Medicine
Co-Investigators: Dr. Michael Bautista, Faculty of Medicine; and, Dr. Elizabeth Woodford, Faculty of Medicine
Dr. DiDonato was awarded a 2019 ARC-NL Research Grant for her project entitled,
Efficacy of the Discretized Analog Scale (DISCAN) Methods for Assessing the Subjective Experience of Pain Intensity Levels During Post-Operative Care in Older Adults.
ARC-NL: Can you please provide a brief synopsis of your specific project?
Pain in the post-operative setting has been traditionally assessed with the Numerical Rating Scale (NRS) and the Visual Analog Scale (VAS). These pain scales have some limitations particularly with an aging cohort: inconsistently sensitive to smaller changes in pain intensity; subject to malingering behaviors; and are less reliable with visually/cognitively impaired individuals. We plan to conduct a clinical trial comparing VAS and NRS pain scales with the discretized analog scale (DISCAN) method. DISCAN used traditionally in psychology, is an innovative clinician administered scale that has applications for pain assessment. Objectives: 1. To investigate the validity/reliability and efficacy of the DISCAN pain assessment method for post-operative inpatient older adults; 2. To determine whether the DISCAN scale correlates to self-controlled analgesia during post-operative care; and, 3. To explore whether specific demographic, health and lifestyle factors influence the reliability of reporting pain intensity levels in older adults. Relevance: Determining the efficacy of the DISCAN pain assessment scale compared to commonly used scales for pain self-assessment is highly relevant for research studies that use pain as outcome measures particularly for older adults.
ARC-NL: How did getting the support of the ARC-NL Research Grant assist you with your project?
The grant from ARC-NL provides essential financial support for the two research assistants to recruit the participants, conduct the study, and for the knowledge translation of the study’s findings to relevant clinical professionals.
ARC-NL: How do you feel your research will benefit the aging population of Newfoundland and Labrador? Canada?
The world’s aging population is growing. In 2016, Newfoundland and Labrador’s population was comprised 19% of older adults 65+ years, with projections to increase to 27% by 2026. Older adults are surviving longer, and with each decade of life the number of chronic conditions increases, some of which impacts on their mobility for pain-free activities of daily living. As a consequence, many older adults are prescribed pain medications and/or undergo surgeries to manage or remediate their pain. Further, age-related cognitive, hearing and visual changes are highly prevalent among older adults. Determining how these chronic diseases influence the validity and reliability of currently used pain assessment scales for an older adult population is particularly important. Specifically, it is important to examine whether the DISCAN method may mitigate some of the shortcomings of pain assessment scales currently in use. Ultimately, an empirically tested tool that results in precise and consistent assessment of pain will allow for improved management of pain, and functional abilities for activities of daily living for older adults.
ARC-NL: Is there any past experience you feel is pertinent to your success today?
I have been employed as a clinical Speech-Language Pathologist since obtaining my master’s degrees in Speech Pathology & Audiology in 1982. I have enjoyed a nearly 40-year career working in hospitals (including Eastern Health) and university settings (currently, Adjunct professor, Faculty of Medicine, Memorial University of Newfoundland). I have had clinical and research opportunities working in the USA, Canada, Norway and the United Kingdom. A large portion of this work has been with older adults with neurogenic cognitive-communication impairments due to stroke, dementia, or brain trauma. In 2014, under the mentorship of Dr. Aimeé Surprenant, in the Psychology Department at Memorial University of Newfoundland, I obtained a PhD in Experimental Cognitive Psychology. The focus of this research was on cognitive aging. My research interest is in cognitive hearing science, communications, and aging. Specifically, I was interested in examining how perceptual-sensory age-related changes (i.e., hearing and vision), influences memory performance for recalling medical prescription information. The findings from these experiments indicated that age-related changes (hearing loss) negatively impacted on the recall of fictional medical prescription information, even when the younger or older adult, had demonstrated that they had heard the information well enough to repeat it immediately. My clinical training and experiences in Audiology and Speech-Language Pathology continues to inform and direct my research interest towards understanding potential causal mechanisms and identifying intervention for and/or prevention of disordered cognition and communication.