Pain management intervention targeting nursing staff and general practitioners: Pain intensity, consequences and clinical relevance for nursing home residents

Dräger, Dagmar; Budnick, Andrea; Kuhnert, Ronny; Kalinowski, Sonja; Könner, Franziska; Kreutz, Reinhold

doi:10.1111/ggi.12924

Cited by 16 publications

(17 citation statements)

References 27 publications

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“…60 Studies of pain in nursing home residents found the prevalence of pain to range between 32%–57%, with more than half of that reported to be moderate-severe pain. 24, 9581 Despite the younger age of our sample, we found a higher prevalence of chronic moderate-severe pain.…”

Section: Discussioncontrasting

confidence: 56%

Characteristics and Factors Associated With Pain in Older Homeless Individuals: Results From the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) Study

Landefeld

Miaskowski

Tieu

et al. 2017

The Journal of Pain

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Individuals experiencing homelessness in the United States are aging; little is known about chronic pain in this population. In a cross-sectional, population-based study, we interviewed 350 homeless individuals aged 50 and older to describe pain experienced by older persons experiencing homelessness and to assess factors associated with chronic moderate to severe pain, defined as pain lasting ≥3 months, with a past week average severity score of 5–10 (scale 0–10). The median age of participants was 58 years. Participants were predominantly African American (79.6%) and male (77.3%). Overall, 46.8% reported chronic moderate to severe pain. Almost half of participants reported a diagnosis of arthritis (44.3%) and one-third reported symptoms consistent with post-traumatic stress disorder (PTSD, 32.8%). Three-quarters (75.3%) endorsed a personal history of abuse. In multivariate analyses, PTSD (AOR: 2.2, CI 1.4–3.7), arthritis (AOR: 4.8, CI 3.0–7.8), and history of experiencing abuse (AOR: 2.4, CI 1.3–4.3) were associated with chronic moderate to severe pain. HIV status, diabetes, depressive symptoms, and substance use were not associated with pain. Clinicians should consider the management of associated mental health conditions and the sequelae of experiencing abuse in the treatment of chronic pain in older adults experiencing homelessness.

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Section: Discussioncontrasting

confidence: 56%

Characteristics and Factors Associated With Pain in Older Homeless Individuals: Results From the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) Study

Landefeld

Miaskowski

Tieu

et al. 2017

The Journal of Pain

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“…Chronic pain is common in NH residents; therefore, improving psychosocial and functional interference from pain is highly relevant to the affected residents' quality of life. Similar to our findings, a cluster‐randomized controlled study that comprised training of NH care workers and general physicians showed a slight (nonsignificant) decrease in residents' interference from pain . In light of the complexity of chronic pain situations, decreasing interference from pain might require a more comprehensive approach.…”

Section: Discussionsupporting

confidence: 85%

“…Unlike similar studies in the field of NH pain management, and despite our small sample size, this study showed significant changes in pain‐related outcomes . Chronic pain is common in NH residents; therefore, improving psychosocial and functional interference from pain is highly relevant to the affected residents' quality of life.…”

Section: Discussioncontrasting

confidence: 52%

“…Implementation efforts in this study were challenged by high turnover in NH staff and leadership, as well as competing interests due to concurrent organizational changes. Developing effective strategies to achieve sustainable changes in NH practice therefore remains a central issue for future research …”

Section: Discussionmentioning

confidence: 99%

“…Unlike similar studies in the field of NH pain management, and despite our small sample size, this study showed significant changes in pain-related outcomes. 16,37,40,41 Chronic pain is common in NH residents; therefore, improving psychosocial and functional interference from pain is highly relevant to the affected residents' quality of life. Similar to our findings, a cluster-randomized controlled study that comprised training of NH care workers and general physicians showed a slight (nonsignificant) decrease in residents' interference from pain.…”

Section: Discussionmentioning

confidence: 99%

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Pain Management in Nursing Home Residents: Findings from a Pilot Effectiveness‐Implementation Study

Brunkert

Simon

Ruppen

et al. 2019

J American Geriatrics Society

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OBJECTIVES To evaluate the effectiveness and implementation of a multilevel pain management intervention in nursing homes (NHs) comprising a pain management guideline, care worker training, and pain champions. DESIGN An implementation science pilot study using a quasi‐experimental effectiveness‐implementation (hybrid II) design. SETTING Four NHs in Switzerland. PARTICIPANTS All consenting long‐term residents aged 65 years and older with pain at baseline (N = 62) and all registered and licensed practical nurses (N = 61). INTERVENTION Implementation of a contextually adapted pain management guideline, interactive training workshops for all care workers, and specifically trained pain champions. MEASUREMENTS Interference from pain, worst and average pain intensity over the previous 24 hours; proxy ratings of pain with the Pain Assessment in Advanced Dementia scale; and care workers' appraisal of the guideline's reach, acceptability, and adoption. RESULTS Pain‐related outcomes improved for self‐reporting residents (n = 43) and residents with proxy rating (n = 19). Significant improvements of average pain from baseline to T1 (P = .006), and in worst pain from baseline to T1 (P = .003) and T2 (P = .004). No significant changes in interference from pain (P = .18). With regard to the implementation efforts, about 76% of care workers indicated they were familiar with the guideline; 70.4% agreed that the guideline is practical and matches their ideas of good pain assessment (75.9%) and treatment (79.7%). CONCLUSION Implementation of a multilevel pain management intervention did significantly improve average and worst pain intensity in NH residents. However, to effect clinical meaningful changes in interference from pain, a more comprehensive approach involving other disciplines may be necessary. J Am Geriatr Soc 67:2574–2580, 2019

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Gesundheitsversorgung im Alter

Schenk

Kuhlmey

Gellert

2022

Medizinische Soziologie in Deutschland

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Pain management intervention targeting nursing staff and general practitioners: Pain intensity, consequences and clinical relevance for nursing home residents

Cited by 16 publications

References 27 publications

Characteristics and Factors Associated With Pain in Older Homeless Individuals: Results From the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) Study

Characteristics and Factors Associated With Pain in Older Homeless Individuals: Results From the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) Study

Pain Management in Nursing Home Residents: Findings from a Pilot Effectiveness‐Implementation Study

Gesundheitsversorgung im Alter

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