Treatment of Pain in European Nursing Homes: Results from the Services and Health for Elderly in Long TERm Care (SHELTER) Study

Lukas, Albert; Mayer, Benjamin; Fialová, Daniela; Topinková, Eva; Gindin, Jacob; Onder, Graziano; Bernabei, Roberto; Nikolaus, Thorsten; Denkinger, Michael

doi:10.1016/j.jamda.2013.04.009

Cited by 56 publications

(64 citation statements)

References 44 publications

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“…A number of studies internationally have identified that pain is often substantially undertreated or untreated in geriatric patients (Daoust et al, 2014, Lukas et al, 2013, Morrison and Siu, 2000, Niruban et al, 2010, and that people with dementia are significantly less likely to receive analgesia than their cognitively intact counterparts (Closs et al, 2004, Hoffman et al, 2014, Morrison and Siu, 2000. There are particular issues with the management of pain for older patients in acute hospital settings (Atkinson and Almahdi, 2014, Carr et al, 2014, Chang et al, 2010, Lin et al, 2014, Niruban et al, 2010.…”

Section: Introductionmentioning

confidence: 99%

Using sense-making theory to aid understanding of the recognition, assessment and management of pain in patients with dementia in acute hospital settings

Dowding

Lichtner

Allcock

et al. 2016

International Journal of Nursing Studies

113

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Background: The recognition, assessment and management of pain in hospital settings is suboptimal, and is a particular challenge in patients with dementia. The existing process guiding pain assessment and management in clinical settings is based on the assumption that nurses follow a sequential linear approach to decision making. In this paper we re-evaluate this theoretical assumption drawing on findings from a study of pain recognition, assessment and management in patients with dementia. Aim:To provide a revised conceptual model of pain recognition, assessment and management based on sense-making theories of decision making. Methods:The research we refer to is an exploratory ethnographic study using nested case sites. Patients with dementia (n= 31) were the unit of data collection, nested in 11 wards (vascular, continuing care, stroke rehabilitation, orthopaedic, acute medicine, care of the elderly, elective and emergency surgery), located in four NHS hospital organizations in the UK. Data consisted of observations of patients at bedside (170 hours in total); observations of the context of care; audits of patient hospital records; documentary analysis of artefacts; semi-structured interviews (n=56) and informal open conversations with staff and carers (family members).Findings: Existing conceptualizations of pain recognition, assessment and management do not fully explain how the decision process occurs in clinical practice. Our research indicates that pain recognition, assessment and management is not an individual cognitive activity; 2 rather it is carried out by groups of individuals over time and within a specific organizational culture or climate, which influences both health care professional and patient behavior. Conclusions:We propose a revised theoretical model of decision making related to pain assessment and management for patients with dementia based on theories of sense-making, which is reflective of the reality of clinical decision making in acute hospital wards. The revised model recognizes the salience of individual cognition as well as acknowledging that decisions are constructed through social interaction and organizational context. The model will be used in further research to develop decision support interventions to assist with the assessment and management of patients with dementia in acute hospital settings.

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Section: Introductionmentioning

confidence: 99%

Using sense-making theory to aid understanding of the recognition, assessment and management of pain in patients with dementia in acute hospital settings

Dowding

Lichtner

Allcock

et al. 2016

International Journal of Nursing Studies

113

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“…Furthermore, a Swedish study represented that Iranian women had a decreased strength with a shorter time of residence (Koochek et al, 2007). Lukas et al (2013) investigated the approaches of pain management in the residents of nursing homes. It has been concluded that treatment approaches for the residents are suboptimal and required substantial improvement.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Quality of Life in Adults Living at Charity Homes in Saudi Arabia

Abdulmageed¹,

Saeed²

2017

GJHS

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There is a rising interest in the Quality of Life (QoL) research in the Arabian countries. The study aimed to analyze the association between the health satisfaction, environment, age, and the physical functions to determine the quality of life among adults living in charity homes in Jeddah, Saudi Arabia. The participants recruited for the study were adults, living in charity homes in Jeddah to analyze the results through a quantitative research design. The sample size included in the study was 136, which included the participants from different charity homes in Jeddah. SF-36 was appropriately used to examine the health status of the participants. WHOQOL-BRIEF questionnaire was used for the collection of primary data at the time of interviews. The statistically significant results have been evaluated through the independent t-test between the groups, based on the characteristics of the participants for average SF-36 domain scores. However, ANOVA test evaluated insignificant results on the basis of educational level as the p-value obtained is greater than the level of significance (0.850>0.05). Positive responses for all four domains of SF-36 instrument have been obtained, which recommended that further improvements in the charity homes is required to provide the awareness regarding the security and medication facilities.

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“…Recent studies conducted with the community (34) and with institutionalized elderly (19) have revealed that chronic pain is most often reported in the legs, which can compromise the performance of activities that require travel/mobility. This finding highlights the need for adequate training of staff working in Nursing Home with regard to the implementation of strategies that ensure pain assessment is performed at rest and during movement at the beginning of the institutionalization, in order to prevent damage and suffering by mis/undertreatment (35) of the experiences, especially of elderly who do not have pain assessment records in institutions and for those with dementia, because they are significantly less likely to receive painkillers (5) . In this sense, the inclusion of pain intensity measurements when assessing functional capacity is an expected conduct of health professionals, especially by nurses and their team.…”

Section: Discussionmentioning

confidence: 99%

Pain intensity among institutionalized elderly: a comparison between numerical scales and verbal descriptors

Pereira

Moura

et al. 2015

Rev. esc. enferm. USP

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Objective: Correlating two unidimensional scales for measurement of self-reported pain intensity for elderly and identifying a preference for one of the scales. Method: A study conducted with 101 elderly people living in Nursing Home who reported any pain and reached > 13 the scores on the Mini-Mental State Examination. A Numeric Rating Scale -(NRS) of 11 points and a Verbal Descriptor Scale (VDS) of five points were compared in three evaluations: overall, at rest and during movement. Results: Women were more representative (61.4%) and the average age was 77.0±9.1 years. NRS was completed by 94.8% of the elderly while VDS by 100%. The association between the mean scores of NRS with the categories of VDS was significant, indicating convergent validity and a similar metric between the scales. Conclusion: Pain measurements among institutionalized elderly can be made by NRS and VDS; however, the preferred scale for the elderly was the VDS, regardless of gender. DESCRIPTORSAged; Scales; Pain Measurement; Health of Institutionalized Elderly. Pain intensity among institutionalized elderly: a comparison between numerical scales and verbal descriptorsIntensidade da dor em idosos institucionalizados: comparação entre as escalas numérica e de descritores verbais Intensidad del dolor en ancianos institucionalizados: comparación entre la escala numérica y los descriptores verbales

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Treatment of Pain in European Nursing Homes: Results from the Services and Health for Elderly in Long TERm Care (SHELTER) Study

Cited by 56 publications

References 44 publications

Using sense-making theory to aid understanding of the recognition, assessment and management of pain in patients with dementia in acute hospital settings

Using sense-making theory to aid understanding of the recognition, assessment and management of pain in patients with dementia in acute hospital settings

Assessment of Quality of Life in Adults Living at Charity Homes in Saudi Arabia

Pain intensity among institutionalized elderly: a comparison between numerical scales and verbal descriptors

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