Kaasalainen Sharon, Zacharias Ramesh, Hill Courtney, Wickson-Griffiths Abigail, Hadjistavropoulos Thomas, Herr Keela
Department of Family Medicine, School of Nursing, McMaster University, Hamilton, Ontario, Canada.
Chronic Pain Management Unit, Chedoke Hospital & Village of Erin Meadows, Hamilton, Ontario, Canada.
Can J Pain. 2017 Oct 26;1(1):171-182. doi: 10.1080/24740527.2017.1383139. eCollection 2017.
: The undermanagement of pain in older adults has been identified as a problem worldwide. : The purpose of this research is to identify priority areas in education and research for future development with the aim of improving pain management in older persons. In addition, barriers to addressing these priorities are identified. : This mixed methods study, based on a modified Delphi approach, included three distinct components: (1) a qualitative component using focus groups with key informants or experts in the field of pain management in older adults ( = 17), (2) a scoping review of the literature, and (3) a survey of ranked responses completed by the same key informants who attended the focus groups. Thematic analysis was used to identify the initial list of issues and descriptive statistics were used for ranking them. : A number of concerns related to both education and research were frequently endorsed by participants. For education, they identified the need for more content in both undergraduate and continuing education programs related to documenting about pain; assessing pain, and learning about the complexities of pain. Research priorities included the need to explore successful practice models; costs of untreated pain; effects of mobility on pain; and patient preferences for pain management. Key barriers to addressing these barriers included lack of staff time and resources and unfamiliarity with pain assessment tools. : These findings highlight priority issues related to pain management in older adults from a nationwide perspective.
老年人疼痛管理不足已被认定为一个全球性问题。本研究的目的是确定教育和研究中的优先领域,以便未来进行发展,旨在改善老年人的疼痛管理。此外,还确定了实现这些优先事项的障碍。这项基于改进的德尔菲法的混合方法研究包括三个不同的部分:(1)一个定性部分,采用与老年人疼痛管理领域的关键信息提供者或专家进行焦点小组讨论(n = 17);(2)对文献的范围审查;(3)对参加焦点小组讨论的相同关键信息提供者完成的排序回复进行调查。采用主题分析来确定问题的初始清单,并使用描述性统计对其进行排序。参与者经常认可一些与教育和研究相关的问题。对于教育,他们确定在本科和继续教育项目中都需要更多与记录疼痛、评估疼痛以及了解疼痛复杂性相关的内容。研究优先事项包括探索成功的实践模式、未治疗疼痛的成本、活动能力对疼痛的影响以及患者对疼痛管理的偏好。解决这些障碍的主要障碍包括缺乏工作人员时间和资源以及对疼痛评估工具不熟悉。这些发现从全国范围的角度突出了与老年人疼痛管理相关的优先问题。