Hadjistavropoulos Thomas, Fitzgerald Theresa Dever, Marchildon Gregory P
Department of Psychology and Centre on Aging and Health, University of Regina, Regina, Saskatchewan, Canada.
Physiother Can. 2010 Spring;62(2):104-13. doi: 10.3138/physio.62.2.104. Epub 2010 Apr 23.
Frail patients with dementia most frequently present with musculoskeletal pain and mobility concerns; therefore, physiotherapy interventions for this population are likely to be of great benefit. However, physiotherapists who work with older adults with dementia confront a considerable challenge: the communication impairments that characterize dementia make it difficult to assess pain and determine its source. For an effective physiotherapy programme to be implemented, valid pain assessment is necessary. This paper is intended to provide practice guidelines for pain assessment among older persons with dementia.
Over the last several years, there has been tremendous research progress in this area. While more research is needed, several promising assessment methodologies are available. These methodologies most often involve the use of observational checklists to record specific pain behaviours.
We encourage the ongoing and regular evidence-based pain assessment of older persons with dementia, using standardized procedures. Without regular and systematic assessment, pain problems will often go undetected in this population. Given the need for systematic pain assessment and intervention for long-term care populations with mobility concerns and muculoskeletal pain problems, we call for increased involvement of physical therapists in long-term care facilities.
患有痴呆症的体弱患者最常出现肌肉骨骼疼痛和行动不便问题；因此，针对这一人群的物理治疗干预可能会带来极大益处。然而，为患有痴呆症的老年人提供治疗的物理治疗师面临着一项重大挑战：痴呆症所特有的沟通障碍使得难以评估疼痛并确定其根源。要实施有效的物理治疗方案，进行有效的疼痛评估是必要的。本文旨在为患有痴呆症的老年人的疼痛评估提供实践指南。
在过去几年中，该领域取得了巨大的研究进展。虽然还需要更多研究，但已有几种有前景的评估方法。这些方法通常涉及使用观察清单来记录特定的疼痛行为。
我们鼓励使用标准化程序，对患有痴呆症的老年人进行持续且定期的循证疼痛评估。如果不进行定期和系统的评估，该人群中的疼痛问题往往会被忽视。鉴于需要对存在行动不便和肌肉骨骼疼痛问题的长期护理人群进行系统疼痛评估和干预，我们呼吁物理治疗师更多地参与长期护理机构的工作。
