Pain Management in Nursing Home Residents: Findings from a Pilot Effectiveness‐Implementation Study.
OBJECTIVES: To evaluate the effectiveness and implementation of a multilevel pain management intervention in nursing homes (NHs) comprising a pain management guideline, care worker training, and pain champions. DESIGN: An implementation science pilot study using a quasi‐experimental effectiveness‐im...
| Publicado en: | Journal of the American Geriatrics Society Vol. 67; no. 12; pp. 2574 - 2581 |
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| Autores principales: | , , , |
| Formato: | Artículo |
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Wiley-Blackwell
Dec2019
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=140248942&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 140248942 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00028614 20Q jtl: Journal of the American Geriatrics Society issn: 00028614 maglogo: Y pubinfo: dt: Dec2019 vid: 67 iid: 12 pid: 480 pub: Wiley-Blackwell artinfo: ui: 140248942 10.1111/jgs.16148 ppf: 2574 ppct: 7 formats: tig: atl: Pain Management in Nursing Home Residents: Findings from a Pilot Effectiveness‐Implementation Study. aug: au: Brunkert, Thekla Simon, Michael Ruppen, Wilhelm Zúñiga, Franziska affil: Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel Switzerland Inselspital Bern University Hospital, Nursing Research Unit, Bern Switzerland Department for Anaesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel Switzerland su: Switzerland Interviewing Self-evaluation Research methodology Research Statistical sampling Surveys Pilot projects Pain measurement Geriatric Depression Scale Descriptive statistics sug: subj: Interviewing Self-evaluation Switzerland Marketing Research and Public Opinion Polling Research methodology Research Statistical sampling Surveys Pilot projects Pain measurement Geriatric Depression Scale Descriptive statistics keyword: implementation study nursing home pain management implementation study nursing home pain management ab: OBJECTIVES: To evaluate the effectiveness and implementation of a multilevel pain management intervention in nursing homes (NHs) comprising a pain management guideline, care worker training, and pain champions. DESIGN: An implementation science pilot study using a quasi‐experimental effectiveness‐implementation (hybrid II) design. SETTING: Four NHs in Switzerland. PARTICIPANTS: All consenting long‐term residents aged 65 years and older with pain at baseline (N = 62) and all registered and licensed practical nurses (N = 61). INTERVENTION: Implementation of a contextually adapted pain management guideline, interactive training workshops for all care workers, and specifically trained pain champions. MEASUREMENTS: Interference from pain, worst and average pain intensity over the previous 24 hours; proxy ratings of pain with the Pain Assessment in Advanced Dementia scale; and care workers' appraisal of the guideline's reach, acceptability, and adoption. RESULTS: Pain‐related outcomes improved for self‐reporting residents (n = 43) and residents with proxy rating (n = 19). Significant improvements of average pain from baseline to T1 (P =.006), and in worst pain from baseline to T1 (P =.003) and T2 (P =.004). No significant changes in interference from pain (P =.18). With regard to the implementation efforts, about 76% of care workers indicated they were familiar with the guideline; 70.4% agreed that the guideline is practical and matches their ideas of good pain assessment (75.9%) and treatment (79.7%). CONCLUSION: Implementation of a multilevel pain management intervention did significantly improve average and worst pain intensity in NH residents. However, to effect clinical meaningful changes in interference from pain, a more comprehensive approach involving other disciplines may be necessary. J Am Geriatr Soc 67:2574–2580, 2019 pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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