The Efficacy, feasibility and usability of using "Pain Check®" as a tool to assist family caregivers in assessing and monitoring the pain of their loved one's with severe dementia

PainChek® is an approved medical device in the form of a smart device App, which combines artificial intelligence and smart automation to identify and quantify pain in real time. The App has been validated and used for assessing pain in people with moderate to severe dementia. PainChek® works by using facial recognition technology and analysis to detect pain through facial muscle movements which indicate the presence of pain. The user then enters other observed pain cues (e.g. vocalisation, movements and behaviours) exhibited by the patient via a series of checklists, and the App automatically calculates a pain score and assigns a pain intensity. The App does not store any images of the patient and adheres to strict medical privacy and confidentiality legislation. Design and setting: This study will be conducted with family carers using PainChek® to assist pain assessment and monitoring of their relatives. The implementation study will be undertaken with assistance of Dementia Support Australia (DSA) consultants. DSA consultants have been using PainChek® since September 2017. Method: DSA consultants will first assess the client for pain using PainChek®. If pain is identified as a potential contributing factor to the client’s behavioural change issues, the DSA consultants will check the eligibility of the family carers and offer them the use of PainChek® via a shared care model as part of the study. If they are interested, DSA consultants will explain the study to them and provide them with a copy of the Participant Information Statements and Information Brochure. Having answered any questions, the interested family carers will then be asked to sign the consent form. Once the consent form is signed, DSA consultants need to photograph it and send a copy to the primary researcher via a prepaid self-addressed envelope. The DSA consultants will then assist the family carers in downloading the App and demonstrate how to use it. The family carers will also be provided with access to online training and support via PainChek Ltd (www.painchek.com) and the primary researcher.The duration of face to face training workshop provided to the family carers is 2.5 hour. At the end of the training duration the DSA consultants will provide the family carers with a survey to complete. Participants will be asked to complete and return the survey in the prepaid self-addressed envelope within 7 days.This survey is divided into three sections and it will not take more than 10-15 minutes. Section A includes 20 statements about users’ (Family carers) perceptions of the potential usefulness of PainChek® as a means of assessing their loved one’s pain. These statements called ‘Health-ITUES’ are rated using a 5-point Likert scale (1= Strongly disagree and 5 = Strongly agree). The Health-ITUES consists of 20 items, with the higher scores correlating to higher technology usability. The 20-item scale consists of four subscales: (1) quality of work life, (2) perceived usefulness, (3) perceived ease of use, and (4) user control. Section B includes questions around the use of mobile technologies, and in Section C, there will be a number of questions about the participants’ age, gender, marital status, living arrangements, educational attainment, and in the case of those people with dementia the type of dementia (vascular, Alzheimer’s, frontotemporal, Lewy’s bodies, or mixed or unknown), degree of cognitive impairment, past medical history and medication history. DSA consultants should recommend the family carers routinely assess (at least once a week) their loved one’s pain for 2 months whilst they are under the care of DSA. When the period of study is finished, family carers will again be asked to complete a short survey about their experience using the app.