Halifax Elizabeth, Miaskowski Christine, Wallhagen Margaret
J Gerontol Nurs. 2018 Apr 1;44(4):29-36. doi: 10.3928/00989134-20180131-01. Epub 2018 Feb 14.
Pain is a significant problem for nursing home residents, yet its assessment is complex. Certified nursing assistants (CNAs) spend significant time with residents, but their role in understanding residents' pain is largely unexplored. The current qualitative grounded theory study analyzed interviews with 16 CNAs who described their experiences caring for residents in pain. Findings revealed how CNAs understood, recognized, interpreted, and responded to residents' pain. CNAs were found to differentiate between pain that they considered normal (everyday pain) and new pain judged significant enough to report to licensed nurses. CNAs exhibited a holistic understanding of pain, knowledge of strategies to identify and interpret pain, and actions to independently mitigate and report pain. Although additional confirmatory data are needed, the differentiation made between everyday and reportable pain may have important clinical implications suggesting that CNAs should always report to a licensed nurse when they perceive or suspect that residents have pain. [Journal of Gerontological Nursing, 44(4), 29-36.].
疼痛是疗养院居民面临的一个重大问题,但其评估很复杂。注册护理助理(CNA)与居民相处的时间很长,但他们在理解居民疼痛方面的作用在很大程度上尚未得到探索。当前的定性扎根理论研究分析了对16名CNA的访谈,这些CNA描述了他们照顾疼痛居民的经历。研究结果揭示了CNA如何理解、识别、解释和应对居民的疼痛。研究发现,CNA能够区分他们认为正常的疼痛(日常疼痛)和认为严重到足以向有执照护士报告的新疼痛。CNA对疼痛表现出全面的理解,掌握识别和解释疼痛的策略知识,以及独立减轻和报告疼痛的行动。尽管需要更多的确证数据,但日常疼痛和可报告疼痛之间的区分可能具有重要的临床意义,这表明当CNA察觉到或怀疑居民疼痛时,应始终向有执照护士报告。[《老年护理杂志》,44(4),29 - 36。]