Rainfray Muriel, Brochet Bruno, de Sarasqueta Anne-Marie, Michel Philippe
Centre de gériatrie Henri Choussat, Hôpital Xavier Arnozan, Groupe hospitalier Sud Pessac (33).
Presse Med. 2003 Jun 7;32(20):924-9.
The assessment and treatment of pain in elderly hospitalised patients are essential elements for the management of these patients. Within the context of a policy aimed at fighting against pain, a transversal survey was conducted at the university hospital centre in Bordeaux to enhance knowledge on pain, its impact and the difficulties in its assessment in these elderly patients.
Analyse the data of this survey concerning patients aged 65 and over, hospitalised in various departments of medicine and in the Geriatric centre.
In this "on a given day" transversal survey, 221 patients underwent self-assessment of their pain using a questionnaire and the numerical scale. 365 patients with cognitive or phasic disorders were assessed using a behavioural scale (Doloplus). The prevalence of pain was calculated in the various departments. The type of pain, its impact, its acknowledgment by the nurses and the physicians and the treatments were described.
The prevalence of pain was of 47.5% in the patients who underwent self-assessment. In the patients who underwent a hetero-assessment, it was of 63.6% in Medicine and 20% in the Geriatric centre. Acute pain predominated in medicine (49%) and chronic pain in the Geriatric centre (52%). The impact of pain on morale was moderate or severe in 60% of patients, and on sleep in 51%. The simultaneous agreement of the nurses and physicians on the pain felt by the patients was of 32% in Medicine and 44.5% in the Geriatric centre.
There is a problem in the acknowledgment of pain in elderly patients. This is related to the systematic non-use of assessment tools and the overlooking of rules for the use of analgesics, particularly in the treatment of chronic pain.
对老年住院患者疼痛的评估和治疗是这些患者管理的重要组成部分。在一项旨在对抗疼痛的政策背景下，波尔多大学医院中心进行了一项横向调查，以增进对这些老年患者疼痛、其影响及评估困难的了解。
分析这项针对65岁及以上在各医学科室和老年医学中心住院患者的调查数据。
在这项“特定日期”横向调查中，221名患者使用问卷和数字量表进行疼痛自评。365名有认知或阶段性障碍的患者使用行为量表（Doloplus）进行评估。计算各科室的疼痛患病率。描述疼痛类型、其影响、护士和医生对疼痛的认知以及治疗情况。
进行自评的患者中疼痛患病率为47.5%。在进行他评的患者中，医学科室为63.6%，老年医学中心为20%。医学科室中急性疼痛占主导（49%），老年医学中心慢性疼痛占主导（52%）。60%的患者疼痛对士气有中度或重度影响，51%的患者疼痛对睡眠有影响。护士和医生对患者疼痛感受的同时认同率在医学科室为32%，在老年医学中心为44.5%。
老年患者疼痛的认知存在问题。这与评估工具的系统性未使用以及镇痛药使用规则的忽视有关，尤其是在慢性疼痛治疗中。
