Kroniske smerter hos sykehjemspasienter - selvrapportering og sykepleiers vurdering
Engelsk titel: Chronic pain in nursing home residents - patients' self-report and nurses' assessment
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Författare:
Nygaard HA
;
Jarland M
Email: harald.nygaard@isf.uib.no
Språk: Nor
Antal referenser: 14
Dokumenttyp:
Artikel
UI-nummer: 05051853
Sammanfattning
BACKGROUND : Nursing home patients who have difficulties communicating are often under-treated for painful conditions. We assessed the agreement between nurses and patients regarding pain. Furthermore, we studied nurses' assessment of pain in non-communicative patients.
MATERIAL AND METHODS : Cross-sectional study, including 157 patients from four nursing homes. Demographic data, diagnoses and clinical information were collected. A study nurse interviewed patients and nurses with regard to pain over the last seven days. Patients who answered this question were regarded as communicative, the others as non-communicative. Cognitive function was assessed by means of the Abbreviated Mental Test.
RESULTS : A total of 109 patients (69%) were capable of answering the question of whether they had felt pain: 42% of the severely, 68% of the slightly or moderately cognitively impaired, and 97% of the cognitively intact patients. 53% of the patients indicated pain. There was agreement between nurses and patients in 77% of the cases (kappa = 0.54), among the severely impaired 33%, among the slightly or moderately impaired 69%, and among of 78% of those cognitively intact. Nurses considered pain to be less prevalent in non-communicative than in communicative patients (44% versus 52%, p = 0.39). Nurses' pain assessment was significantly related to the presence of pain-related diagnoses.
INTERPRETATION : With regard to communicative patients, there was a fairly good/good agreement between patients' report and nurses' assessment of pain. A substantial proportion of the cognitively severely impaired are able to communicate their pain problems.