van Herk Rhodee, Boerlage Anneke A, van Dijk Monique, Baar Frans P M, Tibboel Dick, de Wit Rianne
Pain Expertise Center, Erasmus Medical Center, Rotterdam, The Netherlands.
Pain Manag Nurs. 2009 Mar;10(1):32-9. doi: 10.1016/j.pmn.2008.06.003. Epub 2009 Jan 4.
This cross-sectional multicenter study describes several aspects of pain, pain intensity, and pain treatment in a Dutch nursing home population. A standardized pain questionnaire, including the Numeric Rating Scale (NRS), was used to measure aspects of pain and intensity of present pain, pain experienced in the previous week, and tolerable pain. The eligible sample comprised 320 residents (median age 79 years), of whom 233 residents completed the questionnaire. Sixty-six percent (n = 153) experienced (mostly chronic) pain, either in the previous week (median NRS 6) or at present (median NRS 5). Intolerable pain was recorded in 41% of 100 residents. The higher the pain scores, the more interference with activities of daily living was reported. Of the 153 residents with pain, about one-fourth did not receive any pain medication, and 65 (43%) received step 1, 13 (9%) step 2, and 16 (11%) step 3 analgesics. Most residents (60%) were satisfied with pain treatment, and 21% were not. Considering the high prevalences and intensities of pain, pain management in Dutch nursing homes leaves much to be desired. Apparently, residents do not seem to expect effective pain management. Awareness and knowledge about pain assessment and treatment, however, needs to be raised. Pain measurement tools and treatment protocols should be implemented in daily practice.
这项横断面多中心研究描述了荷兰养老院人群疼痛、疼痛强度及疼痛治疗的几个方面。采用包括数字评定量表(NRS)在内的标准化疼痛问卷,来测量当前疼痛的各个方面及强度、前一周经历的疼痛以及可耐受疼痛。符合条件的样本包括320名居民(中位年龄79岁),其中233名居民完成了问卷。66%(n = 153)的居民在前一周(中位NRS为6)或目前(中位NRS为5)经历过(大多为慢性)疼痛。在100名居民中,4l%记录有无法忍受的疼痛。疼痛评分越高,报告的对日常生活的干扰就越大。在153名有疼痛的居民中,约四分之一未接受任何止痛药物治疗,65名(43%)接受了第1步治疗,13名(9%)接受了第2步治疗,16名(11%)接受了第3步止痛药物治疗。大多数居民(60%)对疼痛治疗满意,21%不满意。考虑到疼痛的高患病率和强度,荷兰养老院的疼痛管理仍有很大的改进空间。显然,居民似乎并不期望有效的疼痛管理。然而,需要提高对疼痛评估和治疗的认识及知识。应在日常实践中实施疼痛测量工具和治疗方案。