Pain Assessment for Older Persons in Nursing Home Care: An Evidence-Based Practice Guideline
| Autor: | Thomas Fischer, Corinna Drebenstedt, Marjan Laekeman, Albert Lukas, Kirsten Kopke, Guideline workgroup, Irmela Gnass, Erika Sirsch |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Evidence-based practice Pain Context (language use) 03 medical and health sciences 0302 clinical medicine Pain assessment medicine Humans 030212 general & internal medicine General Nursing Aged Pain Measurement Aged 80 and over 1103 Clinical Sciences 1110 Nursing 1117 Public Health and Health Services Evidence-Based Medicine business.industry Health Policy General Medicine Guideline Evidence-based medicine Nursing Homes Skill mix Geriatrics Family medicine Evidence-Based Practice Professional association Geriatrics and Gerontology Nursing homes business 030217 neurology & neurosurgery |
| Popis: | Up to 80% of nursing home residents are affected by pain. Pain assessment aims to determine pain intensity, quality, and course of pain to underpin diagnostic decision making. In the nursing home population, pain assessment is frequently compromised by cognitive impairment. Characteristics of the nursing home setting, such as resident's age, staff skill mix, and overall aims of the care provided, also need to be taken into account. Therefore, an interdisciplinary evidence-based clinical practice guideline for pain assessment in the nursing home setting was developed. A systematic literature search was carried out covering publications between 2003 and 2015. Thirty-nine studies were included in the preparation of this guideline, supplemented by 12 international reference guidelines. Recommendations were subjected to a structured consensus-finding process with representatives from 37 scientific and professional organizations and patient representatives. The guideline underwent independent peer review before finalization. It comprises 62 recommendations that are grouped into 4 chapters: (1) context of pain assessment in nursing home care; (2) screening; (3) focused assessment; and (4) reassessment/monitoring of pain. Main recommendations stipulate that clinicians should assess the patient's ability to provide self-report of pain when screening for pain and that each resident should be screened for the presence of pain. A focused assessment of pain, performed during rest and activities, should include pain intensity, changed behaviors, general mobility, pain history, comorbidities, and pain medication. Pain should be re-assessed at regular intervals using the same instruments that were used for the focused assessment. Guideline development demonstrated that many aspects of pain assessment in older persons have not received adequate research attention so far. Available studies predominantly possess only low levels of evidence. Therefore, research into this area needs to be systematically developed to address questions of clinical relevance to support patient care. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|