Differences in Staff-Assessed Pain Behaviors among Newly Admitted Nursing Home Residents by Level of Cognitive Impairment.
Differences in Staff-Assessed Pain Behaviors among Newly Admitted Nursing Home Residents by Level of Cognitive Impairment.
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DOI：
10.1159/000508096
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发表时间：
2020
影响因子：
2.4
通讯作者：
Lapane KL
中科院分区：
文献类型：
--
作者：
Morrison RA;Jesdale BM;Dubé CE;Nunes AP;Bova CA;Liu SH;Lapane KL
疼痛在有认知障碍和痴呆症的养老院居民中很常见。疼痛往往被低估和治疗，这可能导致不利的健康后果。非语言行为是疼痛的有效指标，但这些行为表达在不同程度的认知障碍中的差异程度尚不清楚。这项研究试图检查不同认知障碍程度的疗养院居民疼痛行为患病率的差异。最小数据集3.0版用于识别新入院的疗养院居民有工作人员评估的疼痛(2010-2016，n=1,036,806)。工作人员对疼痛行为进行了评估，包括非言语声音、发声抱怨、面部表情、保护性身体动作或姿势，对无法或不愿自我报告疼痛的居民进行了为期五天的回顾。认知功能量表被用来将居民分为无/轻度、中度或重度认知障碍。改进的泊松模型提供了调整后的患病率(APR)和95%的可信区间(CI)。与无/轻度认知损害(任何疼痛：48.1%)的居民相比，中度认知损害[任何疼痛：42.4%；APR：0.94(95%CI：0.93-0.95)]和重度认知损害[任何疼痛：38.4%；APR：0.86(95%CI：0.85-0.88)]记录疼痛行为的可能性较小。发声疼痛行为在无/轻度认知障碍的居民中很常见(43.5%)，但在有严重认知障碍的居民中较少(20.1%)。与无/轻度认知障碍的居民相比，中度和严重认知障碍的居民记录面部表情和非言语疼痛行为的频率更高。表示疼痛的行为的发生率因认知障碍的程度而异。疼痛评估和管理在治疗和护理结果中起着重要作用。未来的工作应该检查从业者对疼痛行为的感知如何影响他们对疼痛强度和治疗选择的评级。
Pain is common among nursing home residents with cognitive impairment and dementia. Pain is often underdiagnosed and undertreated, which may lead to adverse health outcomes. Non-verbal behaviors are valid indicators of pain, but the extent to which these behavioral expressions vary across levels of cognitive impairment is unknown. This study sought to examine differences in the prevalence of pain behaviors among nursing home residents with varying levels of cognitive impairment. The Minimum Data Set, version 3.0, was used to identify newly admitted nursing home residents with staff-assessed pain (2010–2016, n=1,036,806). Staff assessed pain behaviors included non-verbal sounds, vocal complaints, facial expressions, protective body movements or postures over a five-day look-back period for residents unable or unwilling to self-report pain. The Cognitive Function Scale was used to categorize residents as having no/mild, moderate, or severe cognitive impairment. Modified Poisson models provided adjusted prevalence ratios (aPR) and 95% confidence intervals (CI). Compared to residents with no/mild cognitive impairments (any pain: 48.1%), residents with moderate cognitive impairment [any pain: 42.4%; aPR: 0.94 (95% CI: 0.93–0.95)] and severe cognitive impairment [any pain: 38.4%; aPR: 0.86 (95% CI: 0.85–0.88)] were less likely to have any pain behavior documented. Vocal pain behaviors were common (43.5% in residents with no/mild cognitive impairment), but less so in those with severe cognitive impairment (20.1%). Documentation of facial expressions and non-verbal pain behaviors was more frequent for residents with moderate and severe cognitive impairment than those with no/mild cognitive impairment. The prevalence of behaviors indicative of pain differs by level of cognitive impairment. Pain evaluation and management plays an important role in treatment and care outcomes. Future work should examine how practitioners’ perceptions of pain behaviors influence their ratings of pain intensity and treatment choices.
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影响因子：
3.6
作者：
Achterberg WP;Pieper MJ;van Dalen-Kok AH;de Waal MW;Husebo BS;Lautenbacher S;Kunz M;Scherder EJ;Corbett A
通讯作者：
Corbett A
影响因子：
3.6
作者：
Atee M;Hoti K;Parsons R;Hughes JD
通讯作者：
Hughes JD
影响因子：
3.6
作者：
Kunz, Miriam;Mylius, Veit;Lautenbacher, Stefan
通讯作者：
Lautenbacher, Stefan
DOI：
10.1053/jpmn.2000.5831
发表时间：
2000-03-01
期刊：
Pain management nursing : official journal of the American Society of Pain Management Nurses
影响因子：
--
作者：
Feldt, K S
通讯作者：
Feldt, K S
影响因子：
2.9
作者：
Cohen-Mansfield, J;Creedon, M
通讯作者：
Creedon, M