University Paul Valéry Montpellier 3, University Montpellier, Montpellier, France; Fondation Partage et Vie, Montrouge, France.
University Paul Valéry Montpellier 3, University Montpellier, Montpellier, France.
Pain Manag Nurs. 2021 Jun;22(3):377-385. doi: 10.1016/j.pmn.2020.12.002. Epub 2021 Jan 11.
People with dementia are at great risk of their pain being undetected. In long-term care facilities, certified nursing assistants are on the front-line to detect whether a resident with dementia is experiencing pain, but research on certified nursing assistants' abilities to accurately assess pain are scarce. This study aims to examine certified nursing assistants' pain assessment skills using a simulated standardized video context.
A cross-sectional study was conducted.
Fifty certified nursing assistants and 40 individuals with no professional experience in the field of care (controls) watched the same video of an older adult woman with dementia experiencing pain. Afterwards, they completed visual analog scales (pain intensity, affective distress), an observational pain assessment scale (Algoplus), and a set of questionnaires.
In both groups, pain intensity assessment and empathic reaction scores showed important interrater variability. Moreover, certified nursing assistants and controls did not differ in detecting the presence of pain or assessing its intensity. But certified nursing assistants displayed lower empathic reactions and dispositions. Certified nursing assistants pain assessment scores decreased with experience and expertise.
The practice of pain assessment is challenging for certified nursing assistants in long-term care facilities. Their professional status does not prevent inter-personal inconsistency and tends to lower their empathic dispositions. Personal determinants may interfere with their assessment behaviors and must be considered to enhance pain management for residents with dementia.
痴呆症患者的疼痛很容易被忽视。在长期护理机构中，注册护士助理是第一线人员，负责发现患有痴呆症的居民是否存在疼痛，但关于注册护士助理准确评估疼痛的能力的研究却很少。本研究旨在使用模拟标准化视频环境来检验注册护士助理的疼痛评估技能。
这是一项横断面研究。
五十名注册护士助理和四十名无护理领域专业经验的个体（对照组）观看了同一视频，视频中一名患有痴呆症的老年女性经历疼痛。之后，他们完成了视觉模拟量表（疼痛强度、情感困扰）、观察性疼痛评估量表（Algoplus）和一组问卷。
在两组中，疼痛强度评估和共情反应评分都显示出重要的组内变异性。此外，注册护士助理和对照组在检测疼痛的存在或评估其强度方面没有差异。但是注册护士助理表现出较低的共情反应和倾向。注册护士助理的疼痛评估分数随经验和专业知识的增加而降低。
长期护理机构的注册护士助理在疼痛评估方面存在挑战。他们的职业地位并不能防止人际间的不一致，反而往往会降低他们的共情倾向。个人决定因素可能会干扰他们的评估行为，必须加以考虑，以加强对痴呆症患者的疼痛管理。
