Analgesic Drug Prescription and Use in Cognitively Impaired Nursing Home Residents

Horgas, Ann L.; Tsai, Pao‐Feng

doi:10.1097/00006199-199807000-00009

Cited by 199 publications

(144 citation statements)

References 28 publications

Supporting

Mentioning

128

Contrasting

Unclassified

Order By: Relevance

“…Figures for the USA suggest between 37-47% (Ferrell et al 1990, Horgas & Tsai 1998, Parmalee et al 1993. Similar figures have been reported by investigators within the UK (Allcock et al 2002, Schofield 2005.…”

Section: Introductionsupporting

confidence: 66%

Assessment of pain in adults with cognitive impairment: A review of the tools

Schofield¹,

Clarke²,

Faulkner³

et al. 2005

International Journal on Disability and Human Development

View full text Add to dashboard Cite

The aim of this paper is to discuss the results of a review into the literature related to chronic pain and the older adult. Several themes within the review have been identified and reported elsewhere and the final report has been published by the University of Sheffield in the form of an annotated bibliography. This report focuses upon the findings of the in relation to the assessment of pain in the adult with cognitive impairment. Issues surrounding assessment in the non-cognitively impaired older adult have also been reported elsewhere. For this paper nine studies will be discussed which report the development and testing of pain assessment scales the focus of which is upon behavioural indicators of pain. Some scales have been omitted from the review and the rationale for this decision will be discussed. Each of the selected scales will be discussed and the authors will make recommendations for both clinical practice and for future research based upon the validity, reliability and user friendliness of the scales.From the paper it can be concluded that the Abbey, DOLOPLUS-2 and PACSLAC appear to be the most reliable and valid and in terms of the "user friendliness" would be appropriate to explore further. Recommendations are made for further multi-centre evaluation of these scales.

show abstract

Section: Introductionsupporting

confidence: 66%

Assessment of pain in adults with cognitive impairment: A review of the tools

Schofield¹,

Clarke²,

Faulkner³

et al. 2005

International Journal on Disability and Human Development

View full text Add to dashboard Cite

show abstract

“…However, in elderly patients with advanced dementia who are unable or with reduced capability to describe painful symptoms, other methods of assessment, i.e. behavioral pain assessment methods, might be more appropriate or necessary [8,16,22,33].…”

mentioning

confidence: 99%

Psychometric Properties of the Pain Assessment in Advanced Dementia Scale Compared to Self Assessment of Pain in Elderly Patients

Mosele

Inelmen

Toffanello

et al. 2012

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

Aim: The aims of the present study were to report on the psychometric properties of the Pain Assessment in Advanced Dementia (PAINAD) scale by comparing it with the gold standard method of self-reporting on a numerical rating scale (NRS), and to provide a categorical version of the PAINAD scale comparable with the verbal descriptor scale of the NRS. Methods: Six hundred elderly patients with various degrees of cognitive impairment consecutively admitted to the acute geriatric section at Padua University were evaluated. Cognitive, functional, and health statuses were evaluated using the Mini-Mental State Examination (MMSE), activities of daily living, and the Cumulative Illness Rating Scale (CIRS), respectively. Pain measurements were obtained by administering the NRS and the PAINAD scale. Results: Cognitive decline was recorded in 310 subjects (52%). The internal reliability of the PAINAD scale was adequate for all items, both in patients with dementia (α = 0.90) and in those with no cognitive impairment (α = 0.94). The psychometric evaluation demonstrated a stronger level of concurrent validity (Kendall’s τ = 0.73, p < 0.0001) and inter-rater agreement (ĸ = 0.74, p < 0.0001) for the PAINAD compared with the NRS. Conclusion: Our findings clearly indicate that the PAINAD scale is a reliable and easily administered tool for assessing pain intensity also in elderly patients with advanced dementia.

show abstract

“…A pesar de ello, los estudios y la experiencia en la práctica asistencial como enfermera en unidades de psicogeriatría demuestran que los profesionales sanitarios que atendemos a los pacientes con demencia no disponemos de herramientas para la detección del dolor, lo que evidencia la falta de formación específica sobre su abordaje y gestión 4 . En consonancia con las conclusiones aportadas por las diferentes investigaciones, observamos cómo la falta de capacidad verbal para manifestar dolor en los pacientes con demencia, así como la falta de conocimiento por parte de los profesionales de herramientas para valorarlo, conlleva un infratratamiento del dolor que hace que los pacientes reciban menos analgesia 4,[13][14][15][16] . Autores como Álava y Arriola 11 afirman que un inadecuado control del dolor en estos pacientes produce alteraciones a nivel funcional, cognitivo y afectivo.…”

Section: Discussionunclassified

“…Autores como Horgas y Tsai han descrito que los pacientes ancianos con alteraciones cognitivas reciben menos analgesia que aquellos que pueden comunicar su dolor 13 . En la misma línea, Baeza señala que la falta de capacidad verbal para manifestar el dolor de los pacientes con demencia puede conducir a una infravaloración y, por tanto, a un tratamiento insuficiente 4 .…”

Section: Infradetección E Infratratamientounclassified