Krupic Ferid, Grbic Kemal, Senorski Eric Hamrin, Lepara Orhan, Fatahi Nabi, Svantesson Eleonor
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Anesthesiology. Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Mater Sociomed. 2020 Mar;32(1):50-56. doi: 10.5455/msm.2020.32.50-56.
Patients with hip fracture are one of the most demanding groups in the health-care system. One of the most important tasks for nurses is to assess pain and ensure the patients are pain free. Pain assessment in patients with dementia is a well-known challenge for health-care professionals due to the patients' difficulties in verbalising pain problems.
The aim of this study was to explore the experience of intensive care nurses in assessment of pain in patients with hip fracture and dementia in the postoperative setting.
Data were collected through five focus group discussions using open-ended questions and qualitative content analysis. Twenty-one intensive care nurses (6 men and 15 women) participated in the focus group interviews.
Analysis of the data resulted in three main categories: "Communication", "Visual assessment of pain", and "Practical issues" including a number of subcategories. Some of the factors which influence assessment of pain in patients with dementia are the lack of information and knowledge about the patients, which causes loss of time and increased stress. The different forms of communication and ways of assessing pain in these patients were other factors mentioned by nurses as hindrances regarding assessment of the pain.
In order to improve assessment of pain, more knowledge and information about the patients are needed and better coordination between the pre- and postoperative departments regarding these patients. In this context, different intervention studies on patient's hip fracture and dementia are needed to increase knowledge and awareness regarding this group of patients.
髋部骨折患者是医疗保健系统中需求最为复杂的群体之一。护士最重要的任务之一是评估疼痛并确保患者无痛。由于痴呆症患者在表达疼痛问题方面存在困难,对其进行疼痛评估对医疗保健专业人员来说是一项众所周知的挑战。
本研究的目的是探讨重症监护护士对髋部骨折合并痴呆症患者术后疼痛评估的经验。
通过五次焦点小组讨论收集数据,采用开放式问题和定性内容分析。21名重症监护护士(6名男性和15名女性)参加了焦点小组访谈。
数据分析产生了三个主要类别:“沟通”、“疼痛的视觉评估”和“实际问题”,包括一些子类别。影响痴呆症患者疼痛评估的一些因素包括对患者缺乏信息和了解,这导致时间浪费和压力增加。护士提到的这些患者不同的沟通形式和疼痛评估方式是疼痛评估的其他障碍因素。
为了改善疼痛评估,需要更多关于患者的知识和信息,并且术前和术后科室之间需要就这些患者进行更好的协调。在这种情况下,需要针对患者的髋部骨折和痴呆症进行不同的干预研究,以增加对这组患者的了解和认识。