Integrated Management of Pain in Advanced Dementia
Autor: | Adelaida Zabalegui, José Antonio Rodríguez-Murillo, Marta Garcia‐Pascual, Montserrat Canalias-Reverter, Ester Risco, Mercedes Montoro-Lorite |
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Rok vydání: | 2018 |
Předmět: |
Male
medicine.medical_specialty Wilcoxon signed-rank test MEDLINE Psychological intervention 03 medical and health sciences 0302 clinical medicine Pain assessment Medicine Humans Pain Management 030212 general & internal medicine Nurse education Medical prescription Aged Pain Measurement Advanced and Specialized Nursing Protocol (science) Aged 80 and over Analgesics 030504 nursing business.industry Delivery of Health Care Integrated Reproducibility of Results Mental Status and Dementia Tests Advanced dementia Physical therapy Dementia Female 0305 other medical science business |
Zdroj: | Pain management nursing : official journal of the American Society of Pain Management Nurses. 21(4) |
ISSN: | 1532-8635 |
Popis: | Develop and evaluate the implementation of a protocol for comprehensive management of pain in advanced dementia.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.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 .001) and the control group (rho Spearman: 0.922, p .001). A high correlation was also observed in the IG between assessments conducted using PAINAD-Sp and NRS (intraclass correlation coefficient: 0.921).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. |
Databáze: | OpenAIRE |
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