The Management of Pain in Long-Term Care
The Management of Pain in Long-Term Care
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长期护理中的疼痛管理
DOI：
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发表时间：
2004
期刊：
影响因子：
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通讯作者：
B. Ferrell
中科院分区：
文献类型：
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作者：
B. Ferrell
目的：本文的目的是提出在养老院和其他长期护理设置疼痛管理的突出原则。方法：综述和作者意见。结果：疼痛是养老院和其他长期护理机构的常见问题。疼痛往往未被认识和治疗不足，是痛苦和功能损害的主要来源。这些患者在疼痛评估和管理方面存在很大障碍。多种并发疾病进程、认知障碍和沟通困难，以及获得诊断技术的机会有限，使得评估更加困难。多种药物治疗、生理和药理学改变以及获得各种药物和非药物干预措施的机会有限，使治疗策略更难实施。讨论：考虑到疗养院和其他长期护理机构有限的资源和技能，护理接受长期护理服务的患者的临床医生必须帮助制定合理的治疗计划。应尽可能简化用药方案。疼痛管理的应急计划必须预期和可用，以便在药物更换或剂量调整期间不会发生延误。长期护理机构需要内科医生和其他疼痛专家的大力支持，以不断更新他们的技能和知识。随着对体弱多病老年人卫生系统的需求不断增长，提供适合这些新环境的舒适和有效的疼痛控制非常重要。
Objective:The purpose of this paper is to present salient principles of pain management in nursing homes and other long-term care settings. Methods:Review and author opinion. Results:Pain is a common problem in nursing homes and other long-term care facilities. Often unrecognized and under-treated, pain is a major source of suffering and functional impairment. These patients present substantial barriers to pain assessment and management. Multiple concurrent disease processes, cognitive impairment and communication difficulties, and limited access to diagnostic technologies make assessment more difficult. Multiple medications, altered physiology and pharmacology and limited access to a variety of drug and non-drug interventions make treatment strategies more difficult to implement. Discussion:Clinicians who care for patients receiving long-term care services must help establish a treatment plan that is reasonable given the limited resources and skills available in nursing homes and other long-term care facilities. Medication regimens should be simplified as much as possible. Contingency plans for pain management must be anticipated and made available so that delays do not occur during medication changes or dosage adjustments. Long-term care facilities need substantial support from physicians and other pain experts for education to continuously update their skills and knowledge. As the need for health systems for frail elderly persons continues to grow, it is important to provide comfort and effective pain control appropriate for these new settings.