背景:骨關節炎為老人常見的疾病，也是老人產生疼痛問題最主要的原因之ㄧ。本研究之目的為使用自陳式和疼痛觀察評估工具評估無認知功能障礙之膝骨關節老人的疼痛狀況，並比較其結果的一致性。方法：以方便取樣於北部兩所醫院骨科門診進行收案。老人自陳式疼痛是使用口述疼痛量表來評估，而研究護理師則是使用研究團隊發展的疼痛觀察量表來觀察老人疼痛的表現。結果：大多數的老人自陳正處於輕度到中度的疼痛，但休息時沒有被觀察到任何的臉部表情，僅少數出現身體活動的改變。在活動時，老人最常出現四種疼痛相關的行為，包括額頭有皺紋、輕微的皺眉、活動或步態受限、以及移動的型態改變。比較老人口述疼痛量表和研究護理師疼痛觀察量表的得分發現，僅有移動的型態改變、活動或步態受限、以及輕微的皺眉三個項目的一致性高於50%。結論：本研究結果突顯正確評估老人疼痛的重要性。未來老人和醫療團隊需要一起努力，以改善老人的疼痛評估。

Background: Osteoarthritis (OA) is a common disease among elderly, representing the predominant cause of pain in this population. The purposes of this study were to assess knee OA pain in noncognitively impaired older people by subjective and observed pain-assessment tools and to compare the findings of the two tools. Methods: A convenience sample of elderly was recruited from the orthopaedic outpatient clinics of two hospitals in northern Taiwan. Their self-report pain was measured by the Verbal Rating Scale. Their observed pain was assessed by research nurses using an observed pain-assessment tool. Results: Most participants suffered slight to moderate pain. They did not show any pain-related face expressions but few body movements were observed at rest. During structured activities, participants most commonly showed four pain-related behaviours: wrinkled forehead, slight frown, restricted gait or mobility, and mobility changes. Compared participants’ Verbal Rating Scale score and research nurses’ observed pain-related behaviours, only mobility changes, restricted gait or mobility, and slight frown achieved the consistency greater than 50%. Conclusions: Our findings highlight the importance of appropriately assessing OA pain in elderly patients. Patients and health care providers shall work together to improve pain assessment for elderly.