A literature review exploring how healthcare professionals contribute to the assessment and control of postoperative pain in older people

Abstract

Little research has examined the care older people receive in the acute surgical setting. Although pain assessment and management are judged to be a priority in nursing, often pain, in older people, is undermanaged for a variety of reasons. Factors such as stoicism, communication and ageism can shape both the patients' and nurses' attitude towards the perception of pain which subsequently affects pain management. Through a review of the literature, this paper aims to: (i) identify how healthcare professionals contribute to the assessment and control of postoperative pain in older people and (ii) explore potential barriers to achieving more advantageous pain control in this group. It is suggested that to improve pain management there is a need to individualize pain assessment for older people and to assist clinicians with enhancing their education and decision-making abilities in this field. This may best be achieved by supporting a programme of change to develop the skills of staff and encouraging learning through reflective practice. There is however a need for further research in this area.

A statistical analysis of pain relief after surgical operations

“…Other studies, carried out after more than 10 years, documented a high incidence of uncontrolled and severe pain in hospitals (Donovan et al, 1987;Oden, 1989). The necessity to develop a precise strategy for pain management has been put in evidence later on, in a work by Kuhn et al (1990), and later stressed in several studies examined by systematic reviews such as Kitson (1993) and Brown (2004 Berry and Dahl, 2000;MacLellan, 2004). There is some evidence that extreme suffering from pain could weaken the patient's immune system, while the risk of addiction to pain medication has been shown to be extremely low in patients who received medications for post-operative pain.…”

Predictors of Failed Colonoscopy in Nonagenarians

“…25 This extracaution could prevent complications on one hand but may have contributed to the higher failure rate on the other hand.…”

Perianesthesia Care of the Alzheimer's Patient

“…17 The need for more specific staff education was highlighted in a literature review that was done to (1) identify how health care professionals assess and manage pain in older people and (2) look at possible barriers to achieving pain control in the elderly. 18 Some AD patients can readily communicate their pain but might have developed a lower tolerance for pain than when they were in a healthy state. Others may not communicate appropriately, hence the difficulty on the part of the nurse to understand the individual patient's needs.…”