Understanding pain physiology and its application to person with intellectual disability

Doody, Owen; Bailey, Maria E.

doi:10.1177/1744629517708680

Cited by 23 publications

(15 citation statements)

References 66 publications

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“…There is the position statement with clinical practice recommendations for pain assessment in the patient unable to self-report by Herr et al (2011) and a procedural pain management guideline by Czarnecki et al (2011). Findlay, Williams, Baum, andScior (2015) notes a person with an intellectual disability will often display their pain in ways which can be subtle, and their expressions of pain will be variable and often idiosyncratic (Doody & Bailey, 2019). The International Association for the Study of Pain (2019b) recommends for the older person with an intellectual disability and/ or diagnosis of advanced dementia; then, the use of an appropriate pain assessment tool in conjunction with previously recorded pain baseline observations will be required and a multidimensional approach with continuous reassessment with inclusion of family/caregivers (Findlay et al, 2015).…”

Section: The Findings Show In Some Instances How a Cultural Impositionmentioning

confidence: 99%

Experiences of the older hospitalised person on nursing pain care: An ethnographic insight

Harmon

Summons

Higgins

2019

Journal of Clinical Nursing

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Aims and objectives To present an ethnographic insight into the older hospitalised person (those aged over 65 years) perceptions and experiences of pain care provision by nurses in acute care. Background Pain care provision by nurses remains less than optimal for the older hospitalised person despite numerous evidence‐based guidelines. There is a paucity of research providing input from the experiences of the older hospitalised person in relation to their perspectives of pain care provision by nurses in acute care. Pain care research needs more involvement from those older persons with documented diagnoses of dementia, delirium or cognitive impairment, and intellectual disabilities and those in their end stage of palliation. Design A focused ethnographic study. The consolidated criteria for reporting qualitative research (COREQ) were used to report the findings of this study. Methods A focused ethnographic study was conducted in 8 acute care units within 2 large tertiary referral hospitals on the east coast of Australia. Consisting of semi‐structured interviews (n = 12) of cognitively intact older persons (11 hr). Twenty‐three (23) semi‐structured interviews with nine (9) RN participants (12 hr and 38 min). Participant observation period totalled 1,041 hr. Results The older persons’ experiences of receiving pain care were based on a formulaic assessment process focusing on intensity of pain and pain management options provided often lacked their input. The older persons often did not perceive their pain care provision as being of benefit to themselves. The nurses lacked insight and understanding on the nature of pain for the older person. Conclusion Understanding was gained into how the older persons’ pain care was hampered due to the lack of appropriate, and meaningful pain care provision and provides insight into why the older hospitalised person continues to experience a less than optimal experience. Relevance to clinical practice Older hospitalised persons can gain continuity of pain care when nurses negotiate with them to repattern or restructure their nursing routines for pain care provision. Older people need inclusion into pain care decisions. All vulnerable older persons require nurses to use an evidence‐based pain assessment tool.

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Section: The Findings Show In Some Instances How a Cultural Impositionmentioning

confidence: 99%

Experiences of the older hospitalised person on nursing pain care: An ethnographic insight

Harmon

Summons

Higgins

2019

Journal of Clinical Nursing

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“…If caregivers believe that the person with profound intellectual disabilities cannot experience a high level of pain, they may not give appropriate treatment. Evidence has shown that a person with an intellectual disability may in fact experience pain in a more intense way than those in the general population (Doody & Bailey, 2017b) and polypharmacy can affect the efficacy of analgesic medications (Hall, 2016). Education for caregivers is necessary for improved pain care practices (Findlay et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

The recognition, assessment and perceptions of total pain in people with profound intellectual disabilities: A mixed methods systematic review

Goodall,

Irving,

Nevin

2023

Research Intellect Disabil

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Background: People with profound intellectual disabilities are a population with complex comorbidities. Total pain recognises the interconnectedness of aspects of pain; social, psychological, physical, emotional, spiritual. Pain is under-recognised due to communication challenges and carers perceptions. This review's purpose is to synthesise current literature and provide guidance for future research and care.Methods: Five databases were searched in this mixed methods systematic review (Cinahl, Medline, Psycinfo, Web of Science, Scopus). Articles retrieved were reported via a PRISMA flow diagram. Quality appraisal utilised the mixed methods appraisal tool (MMAT). A convergent qualitative design was the method of data synthesis. Results: Data from 16 included articles generated four themes; Absent voices, reductionist assessment, pain intensity, valuing expertise. Data included physical pain only. Conclusion: Multifaceted pain needs inclusion in research. Assessment must consider the unique expressions of pain by individuals with profound intellectual disabilities. A sharing of expertise may improve pain care. K E Y W O R D S assessment, pain, pain scales, perceptions, profound intellectual disabilities, suffering 1 | BACKGROUND Pain is a subjective unpleasant experience which has a negative effect on an individual's functional ability, and emotional state (Mehta & Chan, 2008). Davis (2000, p. 1) defined pain as involving 'all aspects of our nature from our physiology and biochemistry to our emotional and motivational make up, to our psychological processes and being, to our social relationships and to our sense of spiritual awareness'. It is understood as a multifaceted experience by pivotal authors, incorporating physical, psychological, social and spiritual domains (Cassell, 2004;Saunders, 1993). The interconnectedness of these components interacting upon one another is believed to result in a total pain experience which is specific to each person's particular situation (Krok et al., 2022;Mehta & Chan, 2008;Saunders, 1993).People with profound intellectual disabilities are a population with a very high prevalence of multi-morbidities and chronic pain, and communication challenges can impede the recognition and assessment of this pain (Doody & Bailey, 2017a;McGuire et al., 2010).Understanding that for people with profound intellectual disabilities, pain caused by physical, psychological, social and spiritual factors may contribute to the person's pain experience is essential as a basis for pain assessment. For example an individual may experience chronic physical pain and their distress may increase due to different factors, dependent on the individual, such as changes in surroundings, unfamiliar faces, grief. A person's usual pain behaviours, behaviours of

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“…Assessment [138][139][140][141][142] Intervention of services [143][144][145][146][147] Symptom management [148][149][150][151][152][153][154][155][156][157][158][159][160][161][162][163][164][165]…”

Section: Subthemes Articlesunclassified

Nature and extent of intellectual disability nursing research in Ireland: a scoping review to inform health and health service research

2021

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ObjectivesTo capture the extent and nature of intellectual disability nursing publications in Ireland.DesignScoping review using Arksey and O’Malley approach.Data sourcesSix databases (PsycINFO, CINAHL, Medline, Academic Search Complete, Scopus, Embase) were searched along with a web-based search of the eight academic institutions delivering intellectual disability nurse education in Ireland for publications indexed from the earliest available date to the 31 December 2020.Eligibility criteriaPublications by an academic, practitioner or student working in intellectual disability practice or education in Ireland relating to intellectual disability nursing, care or education.Data extraction and synthesisData pertaining to type of paper/design, authors (academic/professional/student), year, collaboration (national/international), topic/content area and title were extracted from each paper. Data were analysed by two authors using Colorafi and Evans content analysis steps where data was tabulated, and a narrative synthesis undertaken.ResultsThe reporting of the review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and PRISMA extension for Scoping Reviews Checklist. Database and web-based searching resulting 245 articles meeting the criteria for this review. Through content analysis the 245 articles were mapped onto six themes: supporting inclusion, future planning, aspects of health, interventions, education, professional development and research, and personal and professional accounts of caring.ConclusionsThis review highlights the extent and nature of intellectual disability publications by academic, practitioner or student working in intellectual disability nursing in Ireland together with opportunities for future growth and development. From the findings it is apparent that there is an ongoing need for intellectual disability nurses to define their role across the full trajectory of health provision and to make visible their role in person-family centred support, inclusion, and contributions in health education, health promotion and health management.

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Understanding pain physiology and its application to person with intellectual disability

Cited by 23 publications

References 66 publications

Experiences of the older hospitalised person on nursing pain care: An ethnographic insight

Experiences of the older hospitalised person on nursing pain care: An ethnographic insight

The recognition, assessment and perceptions of total pain in people with profound intellectual disabilities: A mixed methods systematic review

Nature and extent of intellectual disability nursing research in Ireland: a scoping review to inform health and health service research

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