Barriers and facilitators in pain management in long-term care institutions: A qualitative study

被引:13
作者
Fox, P
Solomon, P
Raina, P
Jadad, A
机构
[1] St Michaels Hosp, Mobil Program, Clin Res Unit, Toronto, ON M5B 1W8, Canada
[2] McMaster Univ, Sch Rehabil Sci, Hamilton, ON L8S 4L8, Canada
[3] McMaster Univ, Evidence Based Pract Ctr, Hamilton, ON L8S 4L8, Canada
[4] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4L8, Canada
[5] Univ Toronto, Dept Hlth Policy, Toronto, ON, Canada
[6] Univ Toronto, Dept Management & Evaluat, Toronto, ON, Canada
[7] Univ Toronto, Dept Anaesthesia, Toronto, ON, Canada
来源
CANADIAN JOURNAL ON AGING-REVUE CANADIENNE DU VIEILLISSEMENT | 2004年 / 23卷 / 03期
关键词
aging; older adults; pain management; long-term care institutions; qualitative study; focus groups; formal caregivers;
D O I
10.1353/cja.2004.0032
中图分类号
R4 [临床医学]; R592 [老年病学];
学科分类号
1002 ; 100203 ; 100602 ;
摘要
The purpose of this study was to identify barriers to the management of pain in long-term care institutions. Formal caregivers practising in four long-term care institutions in Hamilton, Ontario participated in eight focus groups. Participants included 6 physicians, 19 registered nurses, 8 registered practical nurses, 13 health care aides and 8 occupational therapists or physiotherapists. Three types of barriers were found: caregiver-related, patient-related and systems-related. Four themes for facilitating pain management were identified: (a) caregivers knowing the patient, (b) family support, (c) caregivers demonstrating understanding and compassion, and (d) teamwork by caregivers. Formal caregivers practising in long-term care institutions encounter a multitude of barriers that hinder the adequate assessment and treatment of pain, such as caregiver beliefs and knowledge and cognitive impairment in patients. Innovative strategies and strong political will are needed to overcome them.
引用
收藏
页码:269 / 280
页数:12
相关论文
共 34 条
  • [1] Management of pain in elderly patients with cancer
    Bernabei, R
    Gambassi, G
    Lapane, K
    Landi, F
    Gatsonis, C
    Dunlop, R
    Lipsitz, L
    Steel, K
    Mor, V
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 279 (23): : 1877 - 1882
  • [2] WHAT DO NURSES KNOW AND BELIEVE ABOUT PATIENTS WITH PAIN - RESULTS OF A HOSPITAL SURVEY
    BRUNIER, G
    CARSON, MG
    HARRISON, DE
    [J]. JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1995, 10 (06) : 436 - 445
  • [3] Byrne M M, 2001, AORN J, V73, P703, DOI 10.1016/S0001-2092(06)61966-2
  • [4] Management knowledge, attitudes and clinical practice: The impact of nurses' characteristics and education
    Clarke, EB
    French, B
    Bilodeau, ML
    Capasso, VC
    Edwards, A
    Empoliti, J
    [J]. JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1996, 11 (01) : 18 - 31
  • [5] Pain and elderly patients: A survey of nurses' knowledge and experiences
    Closs, SJ
    [J]. JOURNAL OF ADVANCED NURSING, 1996, 23 (02) : 237 - 242
  • [6] Establishing the credibility of qualitative research findings: the plot thickens
    Cutcliffe, JR
    McKenna, HP
    [J]. JOURNAL OF ADVANCED NURSING, 1999, 30 (02) : 374 - 380
  • [7] Pain in cognitively impaired nursing home patients
    Ferrell, BA
    Ferrell, BR
    Rivera, L
    [J]. JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1995, 10 (08) : 591 - 598
  • [8] FERRELL BA, 1993, IMPROVING CARE NURSI
  • [9] FERRELL BA, 1995, QUALITY CARE GERIATR
  • [10] Daily pain, its associates and impact on work load in institutional long-term care
    Finne-Soveri, H
    Tilvis, RS
    [J]. ARCHIVES OF GERONTOLOGY AND GERIATRICS, 1998, 27 (02) : 105 - 114