Kaasalainen Sharon, Coker Esther, Dolovich Lisa, Papaioannou Alexandra, Hadjistavropoulos Thomas, Emili Anna, Ploeg Jenny
McMaster University, Canada.
West J Nurs Res. 2007 Aug;29(5):561-80; discussion 581-8. doi: 10.1177/0193945906295522. Epub 2007 Jun 4.
The purpose of this study is to explore attitudes and beliefs that affect decisions about prescribing and administering pain medications in older adults who live in long-term care (LTC), with a particular emphasis on those with cognitive impairment. At each of the four participating LTC facilities, data were gathered from three separate groups of health care professionals: physicians, registered nurses, and registered practical nurses. Based on grounded theory, a model was developed that highlighted critical decision points for nurses and physicians regarding pain management. The major themes that emerged from the data concerned pain assessment (lack of recognition of pain, uncertainty about the accuracy of pain assessment and diagnosis) and treatment (reluctance to use opioids, working to individualize pain treatments, issues relating to physician trust of the nurse on prescribing patterns). These findings may facilitate the development of innovative approaches to pain management in LTC settings.
本研究的目的是探讨影响长期护理（LTC）机构中老年人疼痛药物处方和给药决策的态度和信念，尤其关注认知障碍者。在四个参与研究的长期护理机构中，从三组不同的医疗保健专业人员收集数据：医生、注册护士和注册执业护士。基于扎根理论，开发了一个模型，突出了护士和医生在疼痛管理方面的关键决策点。数据中出现的主要主题涉及疼痛评估（对疼痛缺乏认识、疼痛评估和诊断准确性的不确定性）和治疗（不愿使用阿片类药物、努力使疼痛治疗个性化、医生对护士处方模式的信任问题）。这些发现可能有助于在长期护理环境中开发创新的疼痛管理方法。
