Even though the majority of home care clients in this representative study suffered from pain, the degree of pain intensity only becomes an issue in home care if it concurs with impairments in daily living and a corresponding classification to higher levels of care dependency. These findings suggest that pain and pain management should receive more attention in home care, irrespective of observable impairments in daily living. In practice, nurses in home care services should regularly assess the level of pain intensity among home care clients and the results of these regular pain assessments should be taken into account for the identification of individual care needs.

Zusammenfassung Hintergrund Die Bewertung von ambulanter und station?rer Palliativversorgung durch Mitarbeiter und Angeh?rige verstorbener Patienten wurde anhand von Fragen nach der Wahrnehmung der Versorgung des betreffenden Patienten verglichen. Methoden Ein Modul zur Mitarbeiter- und Angeh?rigenzufriedenheit MAAN wurde in 2 HOPE-Dokumentationsphasen in Palliativstationen P, station?ren Hospizen H und ambulanten Teams AT f?r 548 verstorbene Patienten dokumentiert. Die Auswertung erfolgte deskriptiv inkl. demografischen und krankheitsbezogenen Einflussfaktoren aus dem HOPE-Basisbogen auf die Zufriedenheit mit der Versorgung. Ergebnisse Die Bewertung durch die Angeh?rigen war sehr positiv und stimmte weitgehend mit der der Mitarbeiter ?berein. Zufriedenheitsfaktoren waren f?r die Angeh?rigen eine Verweildauer von ?ber 8 Tagen in Palliativstationen, bei den Mitarbeitern in ambulanten Teams eine Tumordiagnose und hohe Symptomlast. Schlussfolgerungen Es gibt eine hohe Zufriedenheit mit der Palliativversorgung. Der MAAN ist ?ber die individuelle Bewertung hinaus zur systemischen Bewertung geeignet.

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Background: There is evidence that knowledge about the prevalence of pain and quality of pain management particularly in nursing home residents (NHR) with severe cognitive impairment (CI) is poor.Methods: The multicenter cross-sectional surveys explored the prevalence of pain of NHR with or without CI from nursing homes in Germany. Actual pain intensity in rest and stress were documented. NHR were asked about their daily restrictions due to pain. Data about the pain management were collected and analyzed.Results: A total of 3437 residents were interviewed with respect to feeling pain, including one third each with mild and severe CI. The prevalence of actual pain was 31,8%. Women reported pain more often. Prevalence of NHR without CI or with self-report on pain was significantly higher than NHR with severe CI or with external report on pain. About 20% of all NHR were dependent on external pain-recording. Nearly 10% of all NHR with pain confirmed pain in stress above 5 on a scale of 0 - 10. 85% of all NHR with pain reported that they had pain for longer than 3 months. Residents with severe CI are 0.55 times less likely to take painkillers than NHR without CI.Conclusion: The study points out a significant deficit in pain management in German NHR with severe CI. Intensive training in pain management for employees in nursing homes is recommended.