Curtiss Carol P
Curtiss Consulting, Greenfield, MA, USA.
Oncol Nurs Forum. 2010 Sep;37 Suppl:7-16. doi: 10.1188/10.ONF.S1.7-16.
PURPOSE/OBJECTIVES: To describe approaches to pain assessment in cognitively intact and cognitively impaired older adults with cancer.
MEDLINE literature search, personal reference collection, and clinical experience.
A systematic and comprehensive pain assessment is the cornerstone of effective treatment strategies. Determining the effect of pain on older adults' ability to function is as important as rating pain intensity. Evidence-based recommendations exist to guide practice.
The undertreatment of pain in older adults persists despite a plethora of published guidelines addressing pain assessment and management. Unrelieved pain affects recovery from illness and all aspects of life. Systematic and ongoing assessment is elementary to effective pain management, yet assessments frequently are neither completed nor documented. Because pain is subjective and individual responses to pain interventions vary widely and are unpredictable, assessment is vital to comprehensive pain care in all clinical settings. Reliable and validated pain assessment tools for cognitively intact and cognitively impaired older adults are available to guide practice.
Pain assessment is a core competency for nurses in all clinical settings. Comprehensive, individualized, and ongoing assessment provides the information necessary so that clinicians can develop interventions to relieve patients' pain and improve their quality of life. Nurses have the knowledge, skills, and tools to adequately screen and comprehensively assess pain in older adult patients, including those with cognitive impairment. By using this knowledge, nurses can change systems and practices, have a significant effect on improving pain care, and increase quality of life and function of older adults with pain.
目的/目标：描述认知功能正常和认知功能受损的老年癌症患者的疼痛评估方法。
医学期刊数据库（MEDLINE）文献检索、个人参考文献收藏以及临床经验。
系统全面的疼痛评估是有效治疗策略的基石。确定疼痛对老年人功能能力的影响与评定疼痛强度同样重要。现有循证建议可指导实践。
尽管有大量关于疼痛评估和管理的已发表指南，但老年患者疼痛治疗不足的情况仍然存在。未缓解的疼痛会影响疾病康复及生活的各个方面。系统且持续的评估是有效疼痛管理的基础，但评估往往既未完成也未记录。由于疼痛是主观的，且个体对疼痛干预的反应差异很大且不可预测，因此评估对于所有临床环境中的全面疼痛护理至关重要。有可靠且经过验证的针对认知功能正常和认知功能受损老年人的疼痛评估工具可用于指导实践。
疼痛评估是所有临床环境中护士的核心能力。全面、个性化且持续的评估提供了必要信息，以便临床医生能够制定干预措施来缓解患者疼痛并改善其生活质量。护士具备知识、技能和工具来充分筛查和全面评估老年患者的疼痛，包括那些有认知障碍的患者。通过运用这些知识，护士可以改变系统和实践，对改善疼痛护理产生重大影响，并提高疼痛老年患者的生活质量和功能。
