Relatives and healthcare staff find it hard to diagnose pain levels in nursing home residents accurately, especially if they are cognitively impaired with illnesses such as dementia or unable to speak, according to a study in September issue of the Journal of Clinical Nursing.
The findings have led experts from The Netherlands to call for nurses to be given more education about how to assess and treat chronic pain. They would also like to see relatives being given more information about pain and for both parties to use other methods, like encouraging greater mobility and providing soothing massages, to alleviate pain.
Researchers led by the Pain Expertise Centre at the Erasmus Medical Center studied 174 nursing home residents - 124 who had cognitive impairments and 50 did not. They also spoke to 171 nurses and 122 relatives.
Six nursing homes took part in the five-year study, with the researchers speaking to the patient, someone responsible for care and, wherever possible, a relative who had regular contact with the patient. In some cases nurses reported back on more than one patient.
Patients were included if they had a pain rating of more than four out of ten, assessed by themselves - if they were not cognitively impaired or a staff nurse if they were. The majority of the 110 women and 64 men, who had an average age of 82, experienced pain as a result of musculoskeletal and circulatory problems.
Previous studies have shown that some people with mild or moderate cognitive impairment are still able to use simple zero to ten scales, where zero is no pain at all and ten is the worse pain imaginable.
In this study, all of the 50 patients in the non-impaired group were able to report pain levels in the previous week, together with 19 in the impaired group, making a total of 69. Fifteen patients in the impaired group were able to report pain levels at rest, making a total of 65.
|Contact: Annette Whibley|