Pain in people with an intellectual disability

McGuire, Brian E.; Kennedy, Susan

doi:10.1097/yco.0b013e32835fd74c

Cited by 30 publications

(37 citation statements)

References 46 publications

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“…The heightened communicative limitations of persons with PID will directly affect their ability to conceptualise their health complaints and to describe them in a way that can be understood by others. This is particularly relevant in relation to pain (Findlay et al 2014), both acute and chronic (McGuire & Kennedy 2013), the correct identification of which in this population continues to pose a health care challenge, despite the efforts made in recent years (De Knegt et al 2013). In this meta-analyses, De Knegt et al examined the association between any observable behaviour and the pain experienced by people with ID over a 20-year period of data recollection and stressed the difficulty of identifying these health complaints accurately.…”

Section: Introductionmentioning

confidence: 99%

Pain underreporting associated with profound intellectual disability in emergency departments

Amor-Salamanca

Menchón

2017

J intellect Disabil Res

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Section: Introductionmentioning

confidence: 99%

Pain underreporting associated with profound intellectual disability in emergency departments

Amor-Salamanca

Menchón

2017

J intellect Disabil Res

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“…Misconceptions by nurses and healthcare professionals regarding people with intellectual disability are that they are seen as a homogenous group, who are insensitive to pain and considered to have a higher pain threshold (Beacroft & Dodd, 2010;Symons, Shinde, & Gilles, 2008). However, this is not substantiated within research (McGuire & Kennedy, 2013) and current opinion is that the low-level reports of pain are due to communication challenges rather than an absence of pain (Cleary & Doody, 2017a;Kerr et al, 2006).…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…People with intellectual disability and dementia experience the same age‐related health conditions as the general population such as arthritis (Doody & Bailey, ; McGuire & Kennedy, ). While many people with intellectual disability live healthier lives than previous generations, they are more likely to experience health conditions than the general population which increase the likelihood of experiencing pain, for example due to musculoskeletal problems (De Knegt & Scherder, ), gastro‐oesophageal reflux and dental/oral disease (Kerr, Cunningham, & Wilkinson, ).…”

Section: Introductionmentioning

confidence: 99%

“…People with intellectual disability and dementia have a right to have their needs met (Health Information & Quality Authority, 2013, 2016McCallion et al, 2017) including their pain needs (McCallion et al, 2017). Historically, people with intellectual disability were perceived as less sensitive to pain (Beacroft & Dodd, 2010) though research has challenged this assumption and generalisation (McGuire & Kennedy, 2013). Nurses must be knowledgeable regarding the possible causes of pain that people with intellectual disability and dementia may experience, how to assess for and recognise pain particularly when a person is unable to self-report and they must facilitate pain-relieving interventions.…”

Section: Introductionmentioning

confidence: 99%

“…People with intellectual disability and dementia experience the same age-related health conditions as the general population such as arthritis (Doody & Bailey, 2017;McGuire & Kennedy, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Nursing people with intellectual disability and dementia experiencing pain: An integrative review

Dillane¹,

Doody

2019

Journal of Clinical Nursing

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Aims and objectives To explore the current evidence of nurses caring for people with intellectual disability and dementia who experience pain. Background People with intellectual disability are ageing and are experiencing age‐related health conditions including dementia and conditions associated with pain, but at an earlier age. Addressing the needs of people with intellectual disability who develop dementia is a new challenge for nurses. Design An integrative literature review. Methods A systematic search of databases: CINAHL, MEDLINE, PsycINFO, Cochrane, EMBASE, Academic Search Complete, Scopus and Web of Science between 27 October 2017–7 November 2017. Hand searching and review of secondary references were also undertaken. Quality appraisal (Crowe Critical Appraisal Tool), thematic data analysis (Braun and Clarke, Qualitative Research in Psychology, 3, 2006, 77) and reporting using the PRISMA guidelines. Results Seven papers met the inclusion criteria, and three themes emerged from this review: nurses knowledge of ageing, dementia and pain; recognising pain in people with intellectual disability and dementia; and the role of nurse education. People with intellectual disability and dementia have difficulty communicating their pain experience compounded by pre‐existing communication difficulties. Conclusions A pain experience can present similar to behavioural and psychological symptoms of dementia, and diagnostic overshadowing often occurs whereby a pain need is misinterpreted as behavioural and psychological symptoms resulting in inappropriate treatment. Nurses need greater knowledge about the presence of pain and potential causes in people with intellectual disability and dementia, and education can be effective in addressing this knowledge deficit. Relevance to clinical practice Pain assessment tools for people with intellectual disability and dementia need to include behavioural elements, and baseline assessments are required to identify changes in presentation. Nurses need to recognise and respond to pain based on the evidence in order to deliver quality care.

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Pain interventions in adults with intellectual disability: A scoping review and pharmacological considerations

Lonchampt

Gerber²,

Aubry³

et al. 2020

European Journal of Pain

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Background and Objective Having to deal on a daily routine with prescriptions in adults with intellectual disability (ID), we systematically reviewed the literature on the specificities of pain interventions in that population, focusing on medication and trying to gather practical information on appropriate pain treatments. Given the scarcity of the literature on the topic, we also discussed the pharmacological considerations to be taken into account when prescribing analgesic drugs in that vulnerable population. Databases and Data Treatment Articles on pain and ID were searched in the Medline and Google scholar electronic databases using the key words "Intellectual Disability," "Developmental Disability" and specific keywords for pharmacological and non‐pharmacological pain interventions. Preset outcomes about pharmacological treatment specificity, efficacy and safety were then collected. Results One hundred and fifty‐two articles were found and 16 were retained based on our inclusion and exclusion criteria. Of the 16 articles, five were topical reviews. Among the 11 remaining articles, five discussed pharmacological interventions, four considered non‐pharmacological interventions and two discussed both. As anticipated, the literature matching our specific outcomes about the pharmacological treatment of pain was scarce and for the most part not designed to answer the questions of specificity, efficacy and safety of pain treatment in adults with ID. Conclusion The specificity of analgesic treatments in adults with ID is a totally unexplored domain. In the absence of clinical guidelines, pharmacological facts—such as inter‐individual variability in drug response, pharmacokinetic and pharmacodynamic interactions, frequent co‐morbidities and ease of administration—must be systematically integrated, when prescribing in the population of adults with ID. Significance This review synthesizes the state of research on pain interventions in adults with ID and is one of the rare articles addressing the specificities of analgesic prescriptions in this population.

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Pain in people with an intellectual disability

Cited by 30 publications

References 46 publications

Pain underreporting associated with profound intellectual disability in emergency departments

Pain underreporting associated with profound intellectual disability in emergency departments

Nursing people with intellectual disability and dementia experiencing pain: An integrative review

Pain interventions in adults with intellectual disability: A scoping review and pharmacological considerations

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