Assessing pain in verbal older adults

Booker, Staja Q.; Haedtke, Christine

doi:10.1097/01.nurse.0000473408.89671.52

Cited by 8 publications

(12 citation statements)

References 26 publications

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“…Assessments and diagnoses provide a foundation for treatment planning, implementation, and evaluation based on individualized goals, risks, capabilities, and ordered restrictions. It is important to develop and articulate goals of treatment so that all parties—the patient, caregiver, and members of the health care team—can identify potential areas of disagreement, and be confident that the goals meet the SMART criteria for achieving the desired outcomes of comfort, function, and mood 13. For example, a recommendation to control pain so that standing for 30 seconds within 12 hours and walking 10 steps within 24 hours is tolerable meets these criteria for many patients after surgery.…”

Section: Planning Carementioning

confidence: 99%

CE: Overcoming Movement-Evoked Pain to Facilitate Postoperative Recovery

Booker

Arnstein

Boekel

2023

AJN, American Journal of Nursing

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Severe postoperative movement-evoked pain (MEP) can be immobilizing, instilling in patients the fear that further activity will produce unbearable pain. This impedes healing and restoration of function while also extending time to recovery. Therefore, it is critical to manage MEP effectively through timely evaluation and comprehensive care planning. This article builds on recent calls to standardize testing of MEP to inform care planning in a way that both reduces pain and improves functioning. Subsequent reassessment of MEP can guide the refinement of therapy. Although this approach may seem intuitive, it challenges common practices that focus too heavily on pain intensity, resulting in overtreating, undertreating, or not treating pain, while ignoring the risks of immobility and the importance of movement for improving functional capacity. The authors propose a multifaceted approach to overcoming MEP that nurse clinicians, educators, researchers, and compliance professionals can use to enhance the quality and safety of nursing practice.

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Section: Planning Carementioning

confidence: 99%

CE: Overcoming Movement-Evoked Pain to Facilitate Postoperative Recovery

Booker

Arnstein

Boekel

2023

AJN, American Journal of Nursing

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“…Motor impairments may limit an older adult's ability to use purposeful nonverbal methods of communication (eg, pointing finger to a number or face on a pain scale or hand squeezes to reply yes/no to pain question). Booker and Haedtke 4 provide a table on how to address sensory impairments in older adults when conducting a pain assessment.…”

Section: Pain Assessmentmentioning

confidence: 99%

“…Questions about general well-being should not be substituted for pain assessment because these may elicit socially desirable answers and may not elicit any information about pain. 4,18 Instead questions should explicitly ask about pain or hurt. Although a question such as “How are you feeling?” or “How did you sleep last night?” can elicit information on pain and pain interference from some older adults, for others, this question could represent their affect or mood as opposed to pain.…”

Section: Pain Assessmentmentioning

confidence: 99%

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Assessment and Measurement of Pain in Adults in Later Life

Booker¹,

Herr

2016

Clinics in Geriatric Medicine

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Summary Advancing age and multiple comorbidities heighten the risk of persistent pain in older adults. Therefore, assessment of persistent and acute pain is an important part of preventative and palliative health care in older adults. Using the techniques discussed in this article can assist providers in assessing pain and obtaining self-report from older adults. Box 1 provides a list of geriatric pain resources for readers interested in learning more about this topic.

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“…End-of-life patients with advanced dementia pose additional challenges to assessing pain as atypical pain presentations include agitation, aggression, wandering, or calling out, which may lead to pain being underrecognized by caregivers 6 . It may be important to consider involvement of patients' family members when possible, to assist with pain assessment because of their close connection and knowledge of the patient's subtle indicators of pain 7,8 . Clinicians frequently rely on observational scales to assess pain in nonverbal patients 4 .…”

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confidence: 99%

Interprofessional Healthcare Students' Attitudes, Skills, and Knowledge After Comprehensive Pain Assessment Training in Verbal and Nonverbal Patients

Cook

Kaiser

Walker

et al. 2021

J Hosp Palliat Nurs

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A comprehensive pain assessment is the first step in safe, effective pain management. Few studies have explored variations of strategies and measures for multidimensional pain assessment education in both verbal and nonverbal patients. In this retrospective cohort study, interprofessional health care students enrolled in a palliative care curriculum completed a pain assessment training, which taught the PQRSTA ("palliating factors, precipitating factors, previous treatments, quality, region, radiation, severity, temporal factors and associated symptoms") mnemonic as a strategy for assessing pain in verbal patients and the Pain Assessment in Advance Dementia and Checklist of Nonverbal Pain Indicators measures for nonverbal patients. The purpose of this study was to compare the change in attitudes, self-perceived skills, and knowledge regarding pain assessment before and after the training. Attitudes and self-perceived skills were assessed in the pretraining and posttraining survey, which was analyzed using χ 2 test or Fisher exact test. Students' knowledge responses were analyzed using Wilcoxon signed rank test to assess accuracy of responses compared with the expert defined score. One hundred eighty-two students were included. Results showed a statistically significant improvement in attitudes related to applicability of pain measures and self-perceived skills. Overall, data did not support an increase in knowledge using the PQRSTA mnemonic, or Pain Assessment in Advance Dementia and Checklist of Nonverbal Pain Indicators measures. Future pain trainings should consider training on only 1 nonverbal pain measure, incorporating bedside assessments, and integrating real-time feedback.

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Assessing pain in verbal older adults

Cited by 8 publications

References 26 publications

CE: Overcoming Movement-Evoked Pain to Facilitate Postoperative Recovery

CE: Overcoming Movement-Evoked Pain to Facilitate Postoperative Recovery

Assessment and Measurement of Pain in Adults in Later Life

Interprofessional Healthcare Students' Attitudes, Skills, and Knowledge After Comprehensive Pain Assessment Training in Verbal and Nonverbal Patients

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