Kaasalainen S, Middleton J, Knezacek S, Hartley T, Stewart N, Ife C, Robinson L
Department, McMaster University, Burlington, Ontario, Canada.
J Gerontol Nurs. 1998 Aug;24(8):24-31; quiz 50-1. doi: 10.3928/0098-9134-19980801-07.
The purposes of this study were to examine the relationship between: (1) nurses' ratings of pain and corresponding administration of pain medication to elderly long-term care residents, and (2) cognitive status of the elderly and pain medication orders/administration. Participants were 83 residents, 60 years of age and older, in two groups: cognitively impaired (n = 64), and cognitively intact (n = 19). For comparison purposes, 19 of the cognitively impaired subjects were matched on age and diagnosis to provide control for potentially painful conditions. A retrospective medication review of the resident's charts was conducted to compare medication orders and administration on analgesics that were scheduled and p.r.n. (given as needed). The pain ratings of 25 RNs using a visual analogue scale were correlated with pain medications given to the resident on the day of the rating. Results indicated that RNs' ratings of resident pain and the administration of pain medications were not significantly correlated. In addition, cognitively impaired residents were prescribed significantly less scheduled medication and received significantly less pain medication (either p.r.n. or scheduled) than the cognitively intact elderly. Implications for practice and research are discussed.
（1）护士对老年长期护理居民疼痛的评分以及相应的止痛药物给药情况，以及（2）老年人的认知状态与止痛药物医嘱/给药情况。研究参与者为83名60岁及以上的居民，分为两组：认知受损组（n = 64）和认知未受损组（n = 19）。为了进行比较，在年龄和诊断方面对19名认知受损受试者进行了匹配，以控制潜在的疼痛状况。对居民病历进行了回顾性药物审查，以比较预定和按需（必要时）使用的镇痛药的医嘱和给药情况。25名注册护士使用视觉模拟量表进行的疼痛评分与评分当天给予居民的止痛药物相关。结果表明，注册护士对居民疼痛的评分与止痛药物的给药之间无显著相关性。此外，与认知未受损的老年人相比，认知受损的居民所开的预定药物显著较少，接受的止痛药物（无论是按需还是预定）也显著较少。文中讨论了对实践和研究的启示。
