Predictors of pain in nursing home residents with dementia: a cross-sectional study
Predictors of pain in nursing home residents with dementia: a cross-sectional study
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DOI：
10.1111/j.1365-2702.2010.03695.x
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发表时间：
2011-07-01
影响因子：
4.2
通讯作者：
Hua, Mau-Sun
中科院分区：
文献类型：
--
作者：
Lin, Pei-Chao;Lin, Li-Chan;Hua, Mau-Sun
瞄准本研究的目的是调查痴呆患者的护理活动和疼痛之间的关系，以及限制和疼痛之间的关系。如果痴呆症患者的疼痛没有及时发现或缓解，可能会对他们的身体，心理，社会健康和生活质量产生不利影响。护理活动和约束可能会导致疼痛，但很少有人知道它们是否是痴呆症患者疼痛的真正风险因素。采用横断面研究设计。研究对象为台湾北方两所老人院的112位失智症患者。收集的人口统计学和临床数据包括诊断、镇痛剂、约束、最近的福尔斯等。使用临床痴呆评定量表评估痴呆的严重程度。研究人员在常规护理后立即观察每位参与者，然后使用中文版的晚期痴呆疼痛评估量表记录疼痛水平。约36.6%的受试者的中文版晚期痴呆疼痛评估量表评分高于2分，总体平均评分为1.50（SD 1.81），范围为0-8。只有一名痴呆症患者定期接受止痛药治疗。需要辅助护理的痴呆症患者的疼痛水平高于能够自由活动的患者。疼痛程度与痴呆严重程度呈正相关。痴呆患者疼痛的主要预测因素包括约束、辅助洗澡和辅助转移。研究结果证实了护理活动和疼痛之间的关联，以及痴呆症患者的约束和疼痛之间的关联。正式的护理人员需要在协助居民日常活动时尽量减少疼痛的触发，避免不必要的限制，同时为晚期痴呆症居民提供个性化的常规护理。
Aim. The aim of this study was to investigate the association between care activities and pain and restraint and pain in residents with dementia.Background. If pain in people with dementia is not identified or alleviated in a timely manner, it could lead to an adverse effect on their physical, mental, social health and quality of life. Care activities and restraint might cause pain, but little is known as to whether they are true risk-factors of pain in people with dementia.Design. A cross-sectional research design was employed.Methods. One hundred and twelve people with dementia were chosen from two nursing homes located in northern Taiwan. The demographic and clinical data collected included diagnoses, analgesics, restraints, recent falls, etc. The severity of dementia was assessed using the Clinical Dementia Rating Scale. The researchers observed every participant immediately following instances of routine care and then recorded the level of pain using the Chinese version of the Pain Assessment in Advanced Dementia scale.Results. About 36.6% of the participants had a Chinese version of the Pain Assessment in Advanced Dementia scale score above two points and an overall mean score of 1.50 (SD 1.81) with a range from 0-8. Only one resident with dementia received regular analgesic. Pain level in residents with dementia that needed assisted care was higher than in residents who were able to move about freely. It showed a positive correlation between level of pain and the severity of dementia among residents. The major predictors for pain in residents with dementia included restraint, assisted bathing and assisted transfer.Conclusion. The findings confirm the association between care activities and pain and between restraint and pain in residents with dementia.Relevance to clinical practice. Formal caregivers need to minimise the triggering of pain when they assist residents' daily activities and avoid unnecessary restraints, while offering personalised, conventional nursing care to residents with late-stage dementia.