Towards improved decision support in the assessment and management of pain for people with dementia in hospital: a systematic meta-review and observational study

Abstract

Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 11/2000/05. The contractual start date was in October 2012. The final report began editorial review in October 2015 and was accepted for publication in March 2016. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Heal...

Assessing mentoring: A scoping review of mentoring assessment tools in internal medicine between 1990 and 2019

“…There is also little by way of explanations of the 'conceptual foundations' of the tools [123], compromising understanding of content validity and a dearth of data on the reliability, feasibility and validity data, inter-rater reliability and clinical utility data underline persisting questions as to the validity of what we understand about mentoring as a whole and the theories and program designs built upon prevailing data on the overall data available on mentoring [124,125].…”

Symptom management, nutrition and hydration at end-of-life: a qualitative exploration of patients’, carers’ and health professionals’ experiences and further research questions

“…Bereaved carers in this supplementary analysis expressed concern that pain was under recognised in people unable to verbally communicate, including people with dementia. A recent meta-analysis identified multiple pain assessment tools for patients with dementia, but there was insufficient information on their validity [ 38 ]. Furthermore, several non-verbal pain assessment tools have been developed, although a review concluded these tools do not determine level of pain and further research is needed to test the tools with different patient populations [ 39 ].…”

“…Notably, this supplementary analysis highlights that some carers perceive that the patient’s pain is not being assessed, suggesting that healthcare professionals may not be assessing pain in people with dementia or who are non-verbal, or they are not communicating their assessment to carers. A recent qualitative case study identified that pain assessment tools were not used in practice with patients with dementia, nor were carers included in the pain assessment process [ 38 ]. They propose a new decision support tool for hospital-based healthcare professionals to assess pain in patients with dementia [ 38 ].…”

“…A recent qualitative case study identified that pain assessment tools were not used in practice with patients with dementia, nor were carers included in the pain assessment process [ 38 ]. They propose a new decision support tool for hospital-based healthcare professionals to assess pain in patients with dementia [ 38 ]. This supplementary analysis highlighted that carers want to know how to assess if their relative is in pain, and further consideration is therefore needed of carers’ role in pain assessment.…”

Psychometric Evaluation of the MOBID Dementia Pain Scale in U.S. Nursing Homes

“…One strategy for identifying and evaluating pain in nonverbal older adults with dementia is the use of observational pain behavior scales. However, experts do not currently recommend one particular tool for clinical practice (Closs et al, 2016;Herr, Zwakhalen, & Swafford, 2017;Lichtner et al, 2014). Systematic reviews examining strengths and limitations for available observation-based pain assessment tools have concluded that more psychometric evaluation and clinical testing of the available tools are needed to support their use (Closs et al, 2016;Herr et al, 2017;Lichtner et al, 2014).…”