Integrated Management of Pain in Advanced Dementia.

Published on Aug 1, 2020in Pain Management Nursing1.595
· DOI :10.1016/J.PMN.2019.12.004
Mercedes Montoro-Lorite2
Estimated H-index: 2
,
Ester Risco8
Estimated H-index: 8
+ 3 AuthorsAdelaida Zabalegui24
Estimated H-index: 24
Sources
Abstract
Abstract Aim Develop and evaluate the implementation of a protocol for comprehensive management of pain in advanced dementia. Method Quasi-experimental study carried out between September 2015 and May 2016 in an acute geriatric unit. Following development of the protocol and nurse training, 22 participants were recruited through consecutive sampling to form the intervention group (IG). Pain assessment was performed using the Pain Assessment in Advanced Dementia Spanish version (PAINAD-Sp) instrument and by nurse report-rating using the Numeric Rating Scale (NRS) and control group, with pain assessment through nurse-report using an NRS. Interventions carried out following perception of pain were done according to the actions algorithm created for this purpose. Follow-up was carried out daily during the hospital stay. Results Some 98% of the actions were performed correctly following the protocol. All (100%) of patients had a scheduled prescription for analgesics. Significant differences between mean pain scores at admission and discharge were found through PAINAD-Sp using a Wilcoxon sign test of −2.9543 (p = .004). Analysis of pain perception scores revealed a statistically significant positive correlation between the number of nonpharmacological actions performed and the pain score values obtained in the IG (rho Spearman: 0.617, p  Conclusions The implementation of an agreed-upon, standardized protocol for comprehensive pain management in advanced dementia, including nurse training, leads to systematic application of all the protocol stages, and therefore better pain management.
📖 Papers frequently viewed together
References36
Newest
AIM: To assess the effectiveness of psychoeducational interventions with respect to burden, anxiety and depression in family caregivers of People With Dementia living at home. BACKGROUND: In dementia, the family assumes the role of main caregiver, maintaining the patient in a good state of health. Nevertheless, burden, anxiety and depression may have negative repercussions in caregivers. Therefore, professional supports through psychoeducational programmes are recommended as interventions for im...
Source
Abstract Pain management in advanced dementia is complex because of neurological deficits present in these patients, and nurses are directly responsible for providing interventions for the evaluation, management and relief of pain for people suffering from this health problem. In order to facilitate and help decision-makers, pain experts recommend the use of standardised protocols to guide pain management, but in Spain, comprehensive pain management protocols have not yet been developed for adva...
Source
Resumen La gestion del dolor en demencia avanzada es compleja debido a los deficits neurologicos presentes en este tipo de pacientes, siendo las enfermeras directamente responsables de proporcionar intervenciones para la evaluacion, manejo y alivio del dolor a las personas que sufren este problema de salud. Para facilitar y ayudar a la toma de decisiones, los expertos en dolor recomiendan la utilizacion de protocolos estandarizados que guien en el manejo del dolor, pero en Espana no se han desar...
Source
#1Yi-Heng Chen (Mackay Medical College)H-Index: 6
#2Li-Chan Lin (NYMU: National Yang-Ming University)H-Index: 29
Many strategies have been used to improve pain management in institutionalized care settings, but there is no consensus on the effects of these methods. The study purpose was to compare the effect of a Pain Recognition and Treatment (PRT) protocol coupled with basic pain education (experimental group) versus basic pain education alone (control group) in (1) improving the pain management performance of registered nurses (RNs) and (2) reducing pain-related expressions of residents with dementia po...
Source
Background: Pain is under-detected and undertreated in people with dementia. The present study investigates the prevalence of pain in people with dementia hospitalized in nursing homes that are members of National Association of Third Age Residences (ANASTE) Calabria, and evaluates the association among pain, mood, and behavioral and psychological symptoms of dementia (BPSD).
Source
#1Valentina Lichtner (University of Leeds)H-Index: 11
#2Dawn Dowding (Columbia University)H-Index: 29
Last. S. José Closs (University of Leeds)H-Index: 31
view all 3 authors...
Background Assessment and management of pain in patients with dementia is known to be challenging, due to patients’ cognitive and/or communication difficulties. In the UK, pain in hospital is managed through regular assessments, with the use of pain intensity scores as triggers for action. The aim of this study was to understand current pain assessment practices, in order to later inform the development of a decision support tool designed to improve the management of pain for people with dementi...
Source
#1Sylvia S.C. Ngu (UM: University of Malaya)H-Index: 1
#2Maw Pin Tan (UM: University of Malaya)H-Index: 24
Last. P J H Poi (UM: University of Malaya)H-Index: 15
view all 8 authors...
Abstract Pain assessment in older individuals with cognitive impairment is challenging. Evidence on the performance of pain assessment tools in this population remains limited. The aim of this study was to evaluate the performance of self-reported pain, nurse-reported pain, and observational pain tools among older patients with cognitive impairment using a prospective observational design. In all, 152 older individuals admitted to the acute geriatric ward were recruited through convenience sampl...
Source
#1Karin Torvik (Nord-Trøndelag University College)H-Index: 6
#2Bente Nordtug (Nord-Trøndelag University College)H-Index: 5
Last. May Karin Rognstad (HiOA: Oslo and Akershus University College of Applied Sciences)H-Index: 4
view all 4 authors...
Abstract The prevalence of pain ranges from 27.8% to 86.5% in nursing homes and 42% to 50% in home care. Pain assessment is the first step toward effective pain management. The aim of this study was to explore the use of pain assessment strategies (verbal, numeric, and observation rating scales and standardized questions) in home care and nursing homes. The study was a descriptive cross-sectional survey. Health care providers who were responsible for the patients' medications replied to a questi...
Source
#1Elizabeth L Sampson (UCL: University College London)H-Index: 49
#2Nicola WhiteH-Index: 9
Last. Louise JonesH-Index: 42
view all 7 authors...
Pain is underdetected and undertreated in people with dementia. We aimed to investigate the prevalence of pain in people with dementia admitted to general hospitals and explore the association between pain and behavioural and psychiatric symptoms of dementia (BPSD). We conducted a longitudinal cohort study of 230 people, aged above 70, with dementia and unplanned medical admissions to 2 UK hospitals. Participants were assessed at baseline and every 4 days for self-reported pain (yes/no question ...
Source
Cited By0
Newest
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.