Nurses' perceived barriers to optimal pain management in older adults on acute medical units

Using sense-making theory to aid understanding of the recognition, assessment and management of pain in patients with dementia in acute hospital settings

“…A number of studies have highlighted particular issues faced by clinical staff when assessing and managing pain in older adults and those with dementia; communication with patients may be problematic if they are unable to express their pain experiences clearly (Coker et al, 2010, Manias, 2012, organizational issues may impact on when older adults receive pain relief (Manias, 2012, Manias et al, 2002, and trying to balance effectively treating pain whilst simultaneously minimizing the side effects of analgesics has been reported as challenging (Manias, 2012). Nurses have been both observed and reported as not using validated tools for the assessment of pain when caring for patients with dementia in the acute hospital, preferring instead to rely on simple questioning and observation of non-verbal cues (Coker et al, 2010, Manias, 2012 judgements being made a (Manias, 2012(Manias, ) [p.1252.…”

Problems and Barriers in Ensuring Effective Acute and Postoperative Pain Management - an International Perspective

“…An analysis of the studies reveals that nurses' opinions influence pain management and their use of analgesia [7,8,16]. A study by Coker et al found that nurses significantly underestimate the assessment of pain intensity and its consequences, the level of pain at rest and in motion as well as overall pain intensity [7].…”

“…In a study of nursing textbooks concerning the issue of pain management in the UK, Ferrell et al found that only 0.5% of the total content concerned pain [7]. Workload is the key problem in pain management supervised by nurses.…”

“…At the national levels (e.g. in China, Great Britain, the Netherlands, Spain, Turkey, USA) the greatest burden of inadequate pain management is borne by the elderly, pregnant and breastfeeding women, children, people coping with addictions to harmful substances, and the mentally ill [6][7][8][9][10][11][12][13][14][15]. There are still significant barriers to comprehensive pain management, limiting the capacity for effective pain management.…”

Reliability and validity of the Turkish version of Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-T)

“…Believing that pain goes along with aging results in treatment failure especially in older adults with cognitive impairment (4). Therefore, health professionals face difficulties in identifying and assessing pain in these patients (5). Since older adults with dementia have further difficulties in expressing their symptoms as a result of their physical and cognitive impairments, it is important for health care providers to appropriately assess their pain (6).…”