Kutschar P, Lex K, Osterbrink J, Lorenzl S
Institut für Pflegewissenschaft und -praxis, Paracelsus Medizinische Privatuniversität, Strubergasse 21, 5020, Salzburg, Österreich.
Schmerz. 2018 Oct;32(5):356-363. doi: 10.1007/s00482-018-0302-x.
Adequate pain management and palliative care structures are of significant importance in residential nursing homes. Whilst professional pain treatment and palliative care measures are frequently implemented for residents with oncological diseases, this is often not the case for residents with neurological disorders. Such a potential undertreatment is even more challenging when the means of interaction and communication with affected persons are aggravated by impairments in cognitive function.
To examine differences in selected health care service characteristics between nursing home residents with Parkinson's disease, Alzheimer's disease and residents diagnosed with cancer.
Secondary data analysis of residents' survey and medical record data from 13 nursing homes as part of the study "Action Alliance Pain-free City Münster".
Compared with residents with Parkinson's disease and cancer, nursing home residents with Alzheimer's disease exhibited significantly more severe impairment in cognitive function, less additional pain-associated diagnoses, shorter length of stay in nursing homes and more indications of pain.
The generally high level of pain in all observed residents elucidates the principle necessity of adequate pain assessment and an interprofessional pain treatment. Furthermore, there seems to be a still unmet need for specifically adapted pain management strategies especially for the steadily increasing number of people with Parkinson's disease and Alzheimer's disease living in nursing homes. This should be a future high priority task for (nursing) practice and research against the background of the vulnerability of nursing home populations.
在养老院中，充分的疼痛管理和姑息治疗结构至关重要。虽然经常为患有肿瘤疾病的居民实施专业的疼痛治疗和姑息治疗措施，但对于患有神经系统疾病的居民来说，情况往往并非如此。当与受影响者的互动和沟通方式因认知功能障碍而受到影响时，这种潜在的治疗不足更具挑战性。
研究帕金森病、阿尔茨海默病养老院居民与被诊断患有癌症的居民在选定的医疗服务特征方面的差异。
作为“明斯特无痛城市行动联盟”研究的一部分，对13家养老院居民的调查和病历数据进行二次数据分析。
与帕金森病和癌症患者相比，患有阿尔茨海默病的养老院居民在认知功能方面表现出更严重的损害，与疼痛相关的额外诊断更少，在养老院的住院时间更短，疼痛迹象更多。
所有观察到的居民普遍存在的高水平疼痛表明了充分疼痛评估和跨专业疼痛治疗的原则必要性。此外，对于生活在养老院中数量不断增加的帕金森病和阿尔茨海默病患者，似乎仍有未满足的对专门定制的疼痛管理策略的需求。鉴于养老院人群的脆弱性，这应成为（护理）实践和研究未来的高度优先任务。
