{"title":"有认知障碍的养老院居民的疼痛患病率和疼痛管理。2014年至2018年德国五项多中心横断面调查结果。","authors":"","doi":"10.1016/j.pmn.2024.05.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p><span>Pain management depends on continuous pain assessment and a pain concept. In particular, pain assessment and treatment are major challenges for nursing home residents (NHR) with </span>cognitive impairment (CI). Many caregivers often lack the knowledge to recognize and appropriately treat pain in this vulnerable group. Little is known about the proportion of NHR who are fundamentally dependent on external assessment for pain due to CI.</p></div><div><h3>Objective</h3><p>The aim of the study was to determine pain prevalence and management among NHR with and without CI. A second objective was to determine the proportion of NHR who are dependent on external assessment for pain.</p></div><div><h3>Methods</h3><p>Information on pain was collected from 3,437 NHR in multicenter cross-sectional surveys in 51 German nursing homes between 2014 and 2018. The presence of current pain in one-to-one interviews was determined as well as dependencies on third-party information, number of daily pain recordings, and administration of medication for pain. The analysis included a contingency table and log regression analyses.</p></div><div><h3>Results</h3><p>Pain prevalence was 24.9% among NHR with severe CI and 40.4% among NHR without CI. Overall, 19.8% of all NHRs relied on a third-party assessment of pain. Significantly, NHR with severe CI were less likely to be classified as having pain (OR 0.51), to be assessed for pain several times a day (OR 0.53) or to receive pain medication (OR 0.55) compared with NHR without CI. No influence on pain management was shown for the type of pain assessment.</p></div><div><h3>Conclusions</h3><p>The study provides evidence of significant deficits in pain management among NHR with moderate and severe CI in nursing homes in Germany. NHR with moderate and severe CI are significantly less likely to be observed for pain or classified as pain sufferers and receive significantly less pain medication than NHR without CI. Intensive training of staff on pain management of NHR with severe CI is recommended.</p></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pain Prevalence and Pain Management in Nursing Home Residents With Cognitive Impairment. Results From Five Multicenter Cross-Sectional Surveys in Germany Between 2014 and 2018\",\"authors\":\"\",\"doi\":\"10.1016/j.pmn.2024.05.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p><span>Pain management depends on continuous pain assessment and a pain concept. In particular, pain assessment and treatment are major challenges for nursing home residents (NHR) with </span>cognitive impairment (CI). Many caregivers often lack the knowledge to recognize and appropriately treat pain in this vulnerable group. Little is known about the proportion of NHR who are fundamentally dependent on external assessment for pain due to CI.</p></div><div><h3>Objective</h3><p>The aim of the study was to determine pain prevalence and management among NHR with and without CI. A second objective was to determine the proportion of NHR who are dependent on external assessment for pain.</p></div><div><h3>Methods</h3><p>Information on pain was collected from 3,437 NHR in multicenter cross-sectional surveys in 51 German nursing homes between 2014 and 2018. The presence of current pain in one-to-one interviews was determined as well as dependencies on third-party information, number of daily pain recordings, and administration of medication for pain. The analysis included a contingency table and log regression analyses.</p></div><div><h3>Results</h3><p>Pain prevalence was 24.9% among NHR with severe CI and 40.4% among NHR without CI. Overall, 19.8% of all NHRs relied on a third-party assessment of pain. Significantly, NHR with severe CI were less likely to be classified as having pain (OR 0.51), to be assessed for pain several times a day (OR 0.53) or to receive pain medication (OR 0.55) compared with NHR without CI. No influence on pain management was shown for the type of pain assessment.</p></div><div><h3>Conclusions</h3><p>The study provides evidence of significant deficits in pain management among NHR with moderate and severe CI in nursing homes in Germany. NHR with moderate and severe CI are significantly less likely to be observed for pain or classified as pain sufferers and receive significantly less pain medication than NHR without CI. Intensive training of staff on pain management of NHR with severe CI is recommended.</p></div>\",\"PeriodicalId\":19959,\"journal\":{\"name\":\"Pain Management Nursing\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-06-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pain Management Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1524904224001656\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain Management Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1524904224001656","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
摘要
背景：疼痛管理取决于持续的疼痛评估和疼痛概念。尤其是对于有认知障碍（CI）的疗养院居民（NHR）来说，疼痛评估和治疗是一项重大挑战。许多护理人员往往缺乏识别和适当治疗这一弱势群体疼痛的知识。人们对因认知障碍而根本依赖外部疼痛评估的 NHR 比例知之甚少：本研究旨在确定有 CI 和无 CI 的 NHR 的疼痛发生率和处理方法。第二个目标是确定因疼痛而依赖外部评估的 NHR 比例：2014 年至 2018 年期间，在德国 51 家疗养院进行的多中心横断面调查中，收集了 3437 名 NHR 的疼痛信息。在一对一访谈中确定了当前是否存在疼痛，以及对第三方信息、每日疼痛记录次数和疼痛用药的依赖性。分析包括或然率表和对数回归分析：结果：有严重 CI 的 NHR 中，疼痛发生率为 24.9%，无 CI 的 NHR 中，疼痛发生率为 40.4%。总体而言，19.8% 的 NHR 依赖第三方对疼痛进行评估。值得注意的是，与无 CI 的 NHR 相比，有严重 CI 的 NHR 被归类为疼痛（OR 0.51）、每天多次接受疼痛评估（OR 0.53）或接受止痛药物治疗（OR 0.55）的可能性较低。疼痛评估类型对疼痛管理没有影响：该研究证明，德国养老院中患有中度和重度 CI 的 NHR 在疼痛管理方面存在明显缺陷。与无 CI 的 NHR 相比，患有中度和重度 CI 的 NHR 接受疼痛观察或被归类为疼痛患者的可能性要低得多，接受的止痛药物也要少得多。建议对工作人员进行有关重度 CI NHR 疼痛管理的强化培训。
Pain Prevalence and Pain Management in Nursing Home Residents With Cognitive Impairment. Results From Five Multicenter Cross-Sectional Surveys in Germany Between 2014 and 2018
Background
Pain management depends on continuous pain assessment and a pain concept. In particular, pain assessment and treatment are major challenges for nursing home residents (NHR) with cognitive impairment (CI). Many caregivers often lack the knowledge to recognize and appropriately treat pain in this vulnerable group. Little is known about the proportion of NHR who are fundamentally dependent on external assessment for pain due to CI.
Objective
The aim of the study was to determine pain prevalence and management among NHR with and without CI. A second objective was to determine the proportion of NHR who are dependent on external assessment for pain.
Methods
Information on pain was collected from 3,437 NHR in multicenter cross-sectional surveys in 51 German nursing homes between 2014 and 2018. The presence of current pain in one-to-one interviews was determined as well as dependencies on third-party information, number of daily pain recordings, and administration of medication for pain. The analysis included a contingency table and log regression analyses.
Results
Pain prevalence was 24.9% among NHR with severe CI and 40.4% among NHR without CI. Overall, 19.8% of all NHRs relied on a third-party assessment of pain. Significantly, NHR with severe CI were less likely to be classified as having pain (OR 0.51), to be assessed for pain several times a day (OR 0.53) or to receive pain medication (OR 0.55) compared with NHR without CI. No influence on pain management was shown for the type of pain assessment.
Conclusions
The study provides evidence of significant deficits in pain management among NHR with moderate and severe CI in nursing homes in Germany. NHR with moderate and severe CI are significantly less likely to be observed for pain or classified as pain sufferers and receive significantly less pain medication than NHR without CI. Intensive training of staff on pain management of NHR with severe CI is recommended.
期刊介绍：
This peer-reviewed journal offers a unique focus on the realm of pain management as it applies to nursing. Original and review articles from experts in the field offer key insights in the areas of clinical practice, advocacy, education, administration, and research. Additional features include practice guidelines and pharmacology updates.
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