Zwakhalen S, Docking R E, Gnass I, Sirsch E, Stewart C, Allcock N, Schofield P
School for Public Health and Primary Care (CAPHRI), Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.
Faculty of Education and Health, Department of Adult Nursing and Paramedic Sciences, University of Greenwich, London, UK.
Schmerz. 2018 Oct;32(5):364-373. doi: 10.1007/s00482-018-0290-x.
We aimed to explore the existing use of pain assessment tools and guidelines, and develop understanding of the practical considerations required to facilitate their use within the nursing home, hospital and community settings.
A self-administered web-based survey was conducted with nurses, health and social care workers with an interest in the assessment of pain in older adults with cognitive impairment. The survey was distributed to participants in Austria, Belgium, Denmark, Germany, The Netherlands, Switzerland and United Kingdom.
Only a minority of staff reported use of (inter-)national or local standards or specific pain assessment tools in daily practice. A range of tools were reported as being used, which varied across country. While participants generally reported that these pain assessment tools were easy/very easy to use, many participants reported that they were difficult to interpret. Assessment is generally performed whilst providing nursing care. This was highlighted in 70-80% of all participating countries. While many of these tools rely on facial expression of pain, facial expressions were considered to be the least useful in comparison to other items. Furthermore findings showed that nurses employed in long-term care settings did not feel that they were educated enough in pain assessment and management.
Our findings suggest that pain education is required across all countries surveyed. This should include a focus on guidelines and standards for assessment and subsequent management of pain. Findings suggest that clinical staff find interpreting facial expressions in relation to pain more difficult.
我们旨在探究疼痛评估工具和指南的现有使用情况，并加深对在养老院、医院和社区环境中促进其使用所需实际考量因素的理解。
对关注认知障碍老年人疼痛评估的护士、卫生和社会护理工作者开展了一项基于网络的自填式调查。该调查分发给了奥地利、比利时、丹麦、德国、荷兰、瑞士和英国的参与者。
只有少数工作人员报告在日常实践中使用了（国际或当地的）标准或特定的疼痛评估工具。据报告使用了一系列工具，且各国情况不同。虽然参与者普遍表示这些疼痛评估工具易于/非常易于使用，但许多参与者称其难以解读。评估通常在提供护理时进行。所有参与调查的国家中有70%-80%都强调了这一点。虽然这些工具中有许多依赖疼痛的面部表情，但与其他项目相比，面部表情被认为最没用。此外，研究结果表明，长期护理机构的护士觉得自己在疼痛评估和管理方面接受的教育不足。
我们的研究结果表明，所有接受调查的国家都需要进行疼痛教育。这应包括关注疼痛评估及后续管理的指南和标准。研究结果表明，临床工作人员发现解读与疼痛相关的面部表情更困难。
