Unspoken pain: its assessment in persons with aphasia

Vries, N.J. de (2025)

Doctoral Thesis

This thesis provides insight into pain in people with aphasia, mapping pain and offering a practical pain protocol for this target group. Literature research shows that there is no method for assessing pain in people who have suffered a stroke and are unable to assess their own pain using a pain scale. Assessing pain in individuals with moderate to severe communication problems or aphasia has been neglected, which means that they may not receive adequate pain treatment. Observational research describes the validity and reliability of two pain observation instruments, the PACSLAC-D and PAIC15, in individuals with aphasia. Results show that pain indicated using self-report pain scales corresponds to pain observed using the pain observation instruments. Most users prefer the self-report pain scale with a combination of numbers, words and faces for people with aphasia. The research team developed a Pain Protocol based on the results of the studies conducted and the wishes, ideas and needs of people with aphasia and healthcare professionals. This protocol is intended for the care of people with aphasia. It consists of seven steps. The protocol and an instructional video are available free of charge on the UNC-ZH website.

• Stroke patients
• Persons with aphasia
• Pain
• Pain assessment
• Self-report pain scales
• Pain observations instruments
• Pain protocol
• Quality of life

• All authors: Vries, N.J. de
• Supervisor: Achterberg, W.P.
• Co-supervisor: Smaling, H.J.A.; Steen, J.T. van der
• Committee: Gussekloo, J.; Jonkers, R.; Oosterman, J.R.; Zwakhalen, S.M.G.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2025-10-10
• ISBN (print): 9789465107851