Pain Management in Elderly People

Ferrell, Bruce A.

doi:10.1111/j.1532-5415.1991.tb05908.x

Cited by 332 publications

(165 citation statements)

References 61 publications

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“…[2] Specific maneuvers that produce pain, such as straight-leg raising and joint motion may be useful in determining a diagnosis. [36] It is particularly important in the cognitively impaired older adult to search for the presence of pathologic conditions known to be painful and common in this population, including arthritis, old fracture site pain, peripheral neuropathy, and infections (particularly pneumonia, urinary tract infection, and skin and soft tissue infections), as well as procedures associated with pain. […”

Section: Physical Examination and Health Historymentioning

confidence: 99%

“…[20] [93] This means that a large proportion of older adults experiencing chronic pain will have significant depressive symptoms at some time and may benefit dramatically from psychological or psychiatric intervention. [36] [41] Recognition and effective treatment of the underlying pain may alleviate the patient's depressed mood; however, when this is not the case, it is crucial to treat the concomitant mood disorder because failure to do so results in ineffective pain management. Further, the assessment of mood, especially depression, is an essential component of the comprehensive pain assessment with older adults because mood states may alter pain perception or enhance pain intensity.…”

Section: Psychosocial and Functional Assessmentmentioning

confidence: 99%

“…[36] For example, a recent meta-analysis established that from 60% to 70% of elderly postoperative patients develop delirium [30] and that up to 80% of cases were undiagnosed by physicians (32% of cases missed by nurses). [49] Delirium is characterized by a disturbance in consciousness, impaired attention, and changes in cognitive abilities.…”

Section: Psychosocial and Functional Assessmentmentioning

confidence: 99%

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Assessment and measurement of pain in older adults

Herr

Garand

2001

Clinics in Geriatric Medicine

347

251

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Although the empirical base is still limited when providing clear directions for pain assessment and management in older adults, it is possible to identify recommendations for guiding practice based on consensus and a developing scientific base to support best practice activities. This article offers a brief overview of the epidemiology and consequences of pain, followed by a summary of issues and approaches relevant to pain assessment in older adults. Cohort specific recommendations for comprehensive pain assessment and measurement are then addressed. Prevalence and Consequences of Pain in Older AdultsOlder individuals frequently suffer from both acute and chronic painful diseases, have multiple diseases, and take numerous pain medications, [2] although relatively little investigative or clinical attention has been paid to the assessment of pain in the geriatric population, compared with the general population. This is surprising because populationbased figures indicate that the prevalence of pain is twofold higher in those over age 60 (250 per thousand), compared with those under age 60 (125 per thousand). [24] [79] [108] Further, prevalence estimates suggest that approximately 60% of community-dwelling older adults and up to 80% of elderly long-term care facility residents experience substantial pain.[24] [79] [108] Because pain is often remediable, [2] [25] it is thought that the high prevalence estimates of unrelieved pain in elderly persons may result from underrecognition, which in turn results in undertreatment. [65] [91] [120] The consequences of untreated pain can profoundly impact the older person's quality of life. In addition to physiologic risks associated with untreated pain (e.g., cough suppression with subsequent retention of pulmonary secretions), depression, [58] [39] [90] Therefore, it is imperative that health care professionals' knowledge and skills related to pain assessment in older adults be improved, and aggressive approaches to comprehensive pain assessment be adopted, to ensure and improve the quality of life of our senior citizens. Approaches to Pain Assessment with Older Adults Clinical AssessmentIn the clinical setting, accurate assessment of pain is critical for the identification of appropriate interventions and for evaluating the effectiveness of such interventions. Patients should be assessed regularly for the presence of pain and for improvement, deterioration, or complications attributable to pain treatment.[2] The frequency of the follow-up should be a function of the severity of the pain and the potential for adverse effects of treatment. Documentation of pain assessment formalizes the pain assessment process and is essential in the provision of individualized care from both a legal and professional perspective. [17] Inherent in the assessment of pain among older adults is the understanding of its potentially remediable components. For example, if a patient has acute pain, assessment should focus on the underlying pathology responsible for the pain stimulus. If th...

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Section: Physical Examination and Health Historymentioning

confidence: 99%

Section: Psychosocial and Functional Assessmentmentioning

confidence: 99%

Section: Psychosocial and Functional Assessmentmentioning

confidence: 99%

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Assessment and measurement of pain in older adults

Herr

Garand

2001

Clinics in Geriatric Medicine

347

251

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“…Esses achados assemelham-se aos encontrados em pesquisas nacionais, visto que em estudo sobre dor em idosos asilados relataram prevalência que variou de 71% a 83% (18)(19) . A dor compromete gravemente o desempenho do doente geriátrico, resulta em menor capacidade para executar as atividades de vida diária e compromete a qualidade de vida diária (20)(21) . A dor crônica na terceira idade pode apresentar importantes complicações tais como depressão, ansiedade, isolamento social, distúrbios do sono, agitação, agressividade, comprometimento da função cognitiva, incapacidade funcional e diminuição da qualidade de vida, levando a dependência em atividades de vida diária e a um maior gasto com serviços sociais (20) .…”

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Influência da dor crônica na capacidade funcional de idosos institucionalizados

Reis

Torres

2011

Rev. Bras. Enferm.

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RESUMO RESUMO RESUMO RESUMO RESUMO Este estudo teve por objetivo analisar a influência da dor quanto à duração, localização e intensidade na capacidade funcional de idosos institucionalizados. Trata-se de um estudo tansversal a partir de uma amostra de 60 idosos. O instrumento foi composto por variáveis sociodemográficas, de saúde, escala numérica de dor e Índice de Barthel. Com a aplicação do Teste Qui-quadrado verificou-se diferença estatística significante entre presença de dor e as atividades: banho (p=0,015) vestir-se (p=0,041), transferência para higiene intima (p=0,001), transferência cama e cadeira (p=0,032), deambulação (p=0,010) e subir escadas (p=0,008) e a pontuação do Índice de Barthel e presença de dor, p<0,000. Diante dos resultados deste estudo constatou-se que a dor interfere de maneira negativa na capacidade funcional dos idosos. Descritores: Descritores: Descritores: Descritores: Descritores: Idoso; Dor; Atividades cotidianas. ABSTRACT ABSTRACT ABSTRACT ABSTRACT ABSTRACT The aim of this study was to analyze the influence of pain, in terms of its duration, location and intensity, on the functional capacity of institutionalized elderly. That was a cross-sectional study carried out with a sample of 60 elderly patients. The instrument was composed by sociodemographic and health variables, the numerical pain scale and the Barthel scale. The Chi-square test showed a significant statistical difference between the presence of pain and the following activities: bathing (p=0.015) dressing (p=0.041), toilet use (p=0.001), bed-chair transfer (p=0.032), ambulation (p=0.010) and stairs climbing (p=0.008) and between total Barthel score and the presence of pain, p<0,000. The results of this study show that pain has a negative effect on the functional capacity of the elderly. Descriptors: Descriptors: Descriptors: Descriptors: Descriptors: Elderly; Pain; Activities of daily living. RESUMEN RESUMEN RESUMEN RESUMEN RESUMEN Este estudio tuvo como objetivo analizar la influencia del dolor cuanto a su duración, localización e intensidad en la capacidad funcional de ancianos internados en instituciones. Se trata de un estudio descriptivo con delineación transversal y una muestra de 60 ancianos. El instrumento se basa en variables sociodemográficas, de salud, escala numérica de dolor e Índice de Barthel. Con la aplicación del Test Chi-cuadrado se verificó que hay diferencia estadística significativa entre la presencia de dolor en las actividades: baño (p=0,015) vestirse (p=0,041), traslado para labores de higiene intima (p=0,001), traspaso a cama y silla (p=0,032), locomoción (p=0,010) y subir escaleras (p=0,008) y entre la puntuación total de Barthel y presencia de dolor, p<0,000. A la vista de los resultados de este estudio se constata que el dolor interfiere de manera negativa en la capacidad funcional de los ancianos. Descriptores Descriptores Descriptores Descriptores Descriptores: Anciano; Dolor; Actividades cotidianas. Submissão INTRODUÇÃO INTRODUÇÃO INTRODUÇÃO INTRODUÇÃO INTRODUÇÃOO crescente processo de en...

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“…Entre as principais causas de dor na população idosa estão as doenças debilitantes como a artrite (3) , doença inflamatória degenerativa das articulações que se instala insidiosa e progressivamente com o passar dos anos (4) . De maneira geral a artrite se inicia com perda da superfície da cartilagem hialina podendo apresentar-se acompanhada de quadro inflamatório (artrite reumatoide) e comprometimento da extremidade óssea (osteoartrite), ocorrendo principalmente nas articulações mais expostas à sobrecarga de peso do corpo.…”

Section: Introductionunclassified

Intervenções de enfermagem para o cuidado de pacientes com artrite: revisão integrativa da literatura

Santos

Carvalho

2012

Rev. Bras. Enferm.

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Rev Bras Enferm, Brasília 2012 nov-dez; 65(6): 1011-8. REVISãOIntervenções de enfermagem para o cuidado de pacientes com artrite: revisão integrativa da literatura ReSUmO Esta revisão integrativa buscou analisar a produção científica relacionada aos cuidados de enfermagem para pacientes com artrite. Foram incluídos 12 estudos experimentais, randomizados e controlados, publicados nas bases de dados CINAHL, MEDLINE, SciELO e LILACS, utilizando os descritores controlados "arthritis" e "nursing". Os resultados apontaram a efetividade de musicoterapia, estimulação elétrica neuromuscular, toque terapêutico e imagem guiada associada a relaxamento, para o tratamento da dor. Ser atendido por enfermeira especialista aumentou a satisfação com o atendimento, melhorou o impacto da doença e aumento a procura por serviços de saúde. Programas educativos específicos para portadores de artrite estimularam a prática de exercícios físicos e aqueles direcionados a pessoas com problemas crônicos em geral mostraram-se efetivos para controlar a dor e a incapacidade funcional. Concluímos que existe um conjunto de intervenções que podem subsidiar a prática de enfermagem baseada em evidências junto aos idosos com artrite. descritores: Artrite; Cuidados de Enfermagem; Idoso. aBStRaCtThis integrative review aimed to analyze the scientific literature related to nursing care for patients with arthritis. Twelve experimental studies were included, randomized and controlled, published in CINAHL, MEDLINE, SciELO and LILACS databases, using the controlled keywords "arthritis" and "nursing". The results indicated the effectiveness of music therapy, neuromuscular electrical stimulation, therapeutic touch and guided imagery associated with relaxation, for the treatment of pain. Being treated by a specialist nurse increased satisfaction with care, improved the impact of the disease and increased the demand for health services. Specific educational programs for people with arthritis stimulated the practice of physical exercises and those targeted to people with chronic conditions in general were effective to control pain and functional disability. We conclude that there is a set of interventions that can support the practice of evidence-based nursing for the elderly people with arthritis. Key words: Arthritis; Nursing Care; Aged. ReSUmeNEsta revisión integradora tuvo como objetivo analizar la literatura científica relacionada con los cuidados de enfermería en pacientes con artritis. Se incluyeron 12 estudios experimentales, los ensayos controlados aleatorios, publicados en las bases de datos CINAHL, MEDLINE, LILACS y SciELO, utilizando las palabras clave controladas "artritis" y "enfermería". Los resultados indican la efectividad de la musicoterapia, la estimulación eléctrica neuromuscular, toque terapéutico y la imaginación guiada asociada con la relajación, para el tratamiento del dolor. Ser tratado por una enfermera especialista aumentó la satisfacción con la atención, la mejora del impacto de la enfermedad y aumentar la demanda de servicios de salu...

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Pain Management in Elderly People

Cited by 332 publications

References 61 publications

Assessment and measurement of pain in older adults

Assessment and measurement of pain in older adults

Influência da dor crônica na capacidade funcional de idosos institucionalizados

Intervenções de enfermagem para o cuidado de pacientes com artrite: revisão integrativa da literatura

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