Post-Operative Pain Management Practices in Patients with Dementia - The Current Situation in Finland

Rantala, Maija; Kankkunen, Päivi; Kvist, Tarja; Hartikainen, Sirpa

doi:10.2174/1874434601206010071

Cited by 21 publications

(26 citation statements)

References 39 publications

(62 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, Kooten (1999) stated repositioning was the most frequently used, whereas cold packs were used rarely for postoperative pain management. Moreover, another study done in Finland regarding postoperative pain management after hip surgery, was congruent with this study in which repositioning was the most commonly used non-pharmacological method of pain management (25). Meanwhile, in a study done by Gelinas and his collogues, it was found out nurses practice simple massaging as a pain relieve method on critical ill patients (26).…”

Section: Utilization Of Non-pharmacological Methods Of Postoperative supporting

confidence: 60%

Utilization of Non-Pharmacological Methods and the Perceived Barriers for Adult Postoperative Pain Management by the Nurses at Selected National Hospitals in Asmara, Eritrea

Kidanemariam

Elsholz

Simel

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Postoperative pain remains a concern to both patients and health care professionals. Non-pharmacological pain relief methods have the potential to complement pharmacological interventions and may offer alternative treatment options. The aim of the study was to assess nurses’ utilization of postoperative nurses’ non-pharmacological pain relief methods and the perceived barriers for their implementation in the National Hospitals. Methods Descriptive cross sectional study was conducted among 154 nurses working at the National Referral Hospitals and Sembel Private Hospital. A standardized five-point Likert-scale questionnaire which assesses nurses' utilization of selected non-pharmacological methods and the perceived barriers for the implementation of those methods were used to collect data. Descriptive statistics for the demographic data, independent samples t-test and one way ANOVA for the nurses’ utilization of the non-pharmacological methods and perceived barriers were used to analyze the data. Statistical significance level was set at P < 0.05. Results The study found that emotional support (45.5%), helping with daily activities (67.5%) and creating a comfortable environment (61%) were reported to be the most frequently used methods, whereas the cognitive-behavioral (5.9%) and physical methods (5.8%) were found with less frequency. The results also show that characteristics, such as the nurses' age (p = 0.013), education (p = 0.012), work experience (p = 0.001) and place of work (p = 0.001), were significantly related to the use of non-pharmacological methods. Among the various perceived barriers, health care system related barriers such as heavy work load (87.7%), shortage of time (84.4%), limited resources (82.5%), deficit in the guidelines for pain management (77.3%), lack of administrative support (76.6%) followed by patient related barriers such as patients uncooperative behavior (57.1%) were identified. Conclusion Only few of the non-pharmacological methods were found to be utilized by the nurses as pain relieving strategies and various perceived barriers are existing among the nurses towards the utilization of these methods. Nurses in these settings need training and education on non-pharmacological pain relief methods, particularly on methods that are utilized less often.

show abstract

Section: Utilization Of Non-pharmacological Methods Of Postoperative supporting

confidence: 60%

Utilization of Non-Pharmacological Methods and the Perceived Barriers for Adult Postoperative Pain Management by the Nurses at Selected National Hospitals in Asmara, Eritrea

Kidanemariam

Elsholz

Simel

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…For example, a recent study in acute care settings in Finland showed very low use of pain instruments following hip fracture surgery. When an instrument was used, it was usually the VAS, which is known to provide unreliable information in people with dementia 59. Compliance in the use of these observational instruments in long-term care settings has also been disappointing.…”

Section: Organizational and Educational Aspects That Challenge Pain Mmentioning

confidence: 99%

Pain management in patients with dementia

Achterberg¹,

Pieper²,

Dalen-Kok³

et al. 2013

CIA

301

253

View full text Add to dashboard Cite

There are an estimated 35 million people with dementia across the world, of whom 50% experience regular pain. Despite this, current assessment and treatment of pain in this patient group are inadequate. In addition to the discomfort and distress caused by pain, it is frequently the underlying cause of behavioral symptoms, which can lead to inappropriate treatment with antipsychotic medications. Pain also contributes to further complications in treatment and care. This review explores four key perspectives of pain management in dementia and makes recommendations for practice and research. The first perspective discussed is the considerable uncertainty within the literature on the impact of dementia neuropathology on pain perception and processing in Alzheimer’s disease and other dementias, where white matter lesions and brain atrophy appear to influence the neurobiology of pain. The second perspective considers the assessment of pain in dementia. This is challenging, particularly because of the limited capacity of self-report by these individuals, which means that assessment relies in large part on observational methods. A number of tools are available but the psychometric quality and clinical utility of these are uncertain. The evidence for efficient treatment (the third perspective) with analgesics is also limited, with few statistically well-powered trials. The most promising evidence supports the use of stepped treatment approaches, and indicates the benefit of pain and behavioral interventions on both these important symptoms. The fourth perspective debates further difficulties in pain management due to the lack of sufficient training and education for health care professionals at all levels, where evidence-based guidance is urgently needed. To address the current inadequate management of pain in dementia, a comprehensive approach is needed. This would include an accurate, validated assessment tool that is sensitive to different types of pain and therapeutic effects, supported by better training and support for care staff across all settings.

show abstract

“…27 Part of the issue may be that health care personnel, such as nurses, are not adequately trained at assessing pain in patients with dementia. 28 Strategies could be considered, such as regular administration as opposed to as-needed administration. 27 A nonblinded randomized controlled trial of 260 independent community-living patients in Finland was conducted to determine whether a specialized geriatric rehabilitation team consisting of physicians, nurses, and allied health professionals could impact length of stay, mortality, and place of residence at 3 months and 1 year.…”

Section: Treatment and Rehabilitationmentioning

confidence: 99%