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长期照护居民疼痛与痴呆的疼痛评估程序评估。

Evaluation of a Pain Assessment Procedure in Long-Term Care Residents With Pain and Dementia.

机构信息

Department of General Practice and Elderly Care Medicine and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.

Department of General Practice and Elderly Care Medicine and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

J Pain Symptom Manage. 2017 Nov;54(5):727-731. doi: 10.1016/j.jpainsymman.2017.07.020. Epub 2017 Jul 15.

Abstract

BACKGROUND

The management of pain in long-term care (LTC) residents with dementia is complex. A prospective exploratory study was conducted to describe the course of pain and pain management strategies following a guideline-based pain assessment procedure in LTC residents with pain and dementia.

MEASURES

Pain observations with the Mobilization Observation Behaviour Intensity Dementia (MOBID-2) Pain Scale, a review of the electronic patient file and pharmacy files and physical examination of LTC residents with pain and dementia.

INTERVENTION

Communication of the assessment results to the attending physician including guideline-based treatment recommendations.

OUTCOMES

After three months, complete follow-up data were obtained for 64 residents. Pain intensity was significantly reduced (P < 0.001). The proportion of residents with persistent pain was 58% and the total number of analgesic prescriptions did not change significantly.

CONCLUSIONS

There is room for improvement regarding pain management in LTC residents with pain and dementia, and performance feedback seems a promising strategy to explore further.

摘要

背景

长期护理(LTC)机构中痴呆患者的疼痛管理较为复杂。本前瞻性探索性研究旨在描述在 LTC 机构中接受基于指南的疼痛评估程序后,伴有疼痛和痴呆的居民的疼痛过程和疼痛管理策略。

措施

使用 Mobilization Observation Behaviour Intensity Dementia(MOBID-2)疼痛量表对伴有疼痛和痴呆的 LTC 居民进行疼痛观察,回顾电子病历和药房档案,并进行体格检查。

干预措施

将评估结果传达给主治医生,包括基于指南的治疗建议。

结果

三个月后,对 64 名居民进行了完整的随访,发现疼痛强度显著降低(P<0.001)。持续性疼痛居民的比例为 58%,镇痛药处方总数无明显变化。

结论

在 LTC 机构中,患有疼痛和痴呆的居民的疼痛管理仍有改进空间,绩效反馈似乎是一种很有前途的策略,值得进一步探索。

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