Nurses' Experiences in Pain Management of Cognitively Impaired Older People With a Fractured Hip in the Acute Setting—An Integrative Review

IF 2 4区医学 Q4 GERIATRICS & GERONTOLOGY

International Journal of Older People Nursing Pub Date : 2025-09-11 DOI:10.1111/opn.70045

Belinda Evelyn Lincoln, Christina Aggar, Samuel Lapkin

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引用次数: 0

Abstract

Background

Managing pain in older people with hip fractures and cognitive impairment, such as dementia or delirium, presents unique challenges in acute care settings. Cognitive impairment can complicate pain assessment and management, making nurses' roles in identifying and addressing pain particularly critical in this population.

Aim

To review the existing research on nurses' experiences in pain management of cognitively impaired older people with a fractured hip in the acute setting.

Design

An integrative review.

Methods

Four databases were searched using the PRISMA framework to guide the search and screening. Eligible studies were identified and the quality of each was evaluated using the Mixed Method Appraisal Tool. Thematic analysis was conducted to identify and analyse key themes across all articles.

Results

Nine studies examined nurses' experiences in managing pain for cognitively impaired older people with a fractured hip in the acute setting. Three key themes were identified: communication challenges, the importance of person-specific knowledge and complexities in analgesia administration.

Conclusion

Nurses recognise the importance of pain management in cognitively impaired older people with a fractured hip. There is a reliance on opioid analgesia balanced with the potential for side effects. Effective pain management is challenged by communication barriers and the need for person-specific knowledge, underscoring the complexity of delivering optimal care in this setting.

Relevance to Clinical Practice

Managing pain in cognitively impaired older people following a hip fracture can be challenging. Nurses are well placed to contribute to and support quality pain assessment and management in cognitively impaired older people with a fractured hip in the acute setting.

Patient or Public Contribution

No direct patient or public contribution to the review.

查看原文本刊更多论文

护理人员在急性髋部骨折认知障碍老年人疼痛管理中的经验——一项综合综述

背景：老年髋部骨折和认知障碍患者的疼痛管理，如痴呆或谵妄，在急性护理环境中提出了独特的挑战。认知障碍会使疼痛评估和管理复杂化，这使得护士在识别和解决疼痛方面的作用在这一人群中尤为重要。目的总结护理人员对老年认知障碍髋部骨折患者急性期疼痛管理的经验。设计：综合评价。方法采用PRISMA框架对4个数据库进行检索，指导检索和筛选。确定符合条件的研究，并使用混合方法评估工具对每个研究的质量进行评估。进行主题分析，以确定和分析所有文章的关键主题。结果9项研究调查了护士在急性髋部骨折认知障碍老年人疼痛管理方面的经验。确定了三个关键主题：沟通挑战，个人特定知识的重要性和镇痛给药的复杂性。结论护士认识到老年髋部骨折认知障碍患者疼痛管理的重要性。对阿片类镇痛的依赖与潜在的副作用是平衡的。有效的疼痛管理受到沟通障碍和对个人特定知识的需求的挑战，强调了在这种情况下提供最佳护理的复杂性。髋部骨折后认知功能受损的老年人疼痛管理具有挑战性。护士很好地帮助和支持在急性髋部骨折的认知受损老年人进行高质量的疼痛评估和管理。患者或公众对本综述没有直接的患者或公众贡献。

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来源期刊

International Journal of Older People Nursing Nursing-Gerontology

CiteScore

3.60

自引率

9.10%

发文量

期刊介绍： International Journal of Older People Nursing welcomes scholarly papers on all aspects of older people nursing including research, practice, education, management, and policy. We publish manuscripts that further scholarly inquiry and improve practice through innovation and creativity in all aspects of gerontological nursing. We encourage submission of integrative and systematic reviews; original quantitative, qualitative, and mixed methods research; secondary analyses of existing data; historical works; theoretical and conceptual analyses; evidence based practice projects and other practice improvement reports; and policy analyses. All submissions must reflect consideration of IJOPN''s international readership and include explicit perspective on gerontological nursing. We particularly welcome submissions from regions of the world underrepresented in the gerontological nursing literature and from settings and situations not typically addressed in that literature. Editorial perspectives are published in each issue. Editorial perspectives are submitted by invitation only.