Pain Interventions for people with dementia: a quasi-experimental study.
Nursing home
Pain management
People with dementia
Work-based learning
Work-related learning
Journal
BMC palliative care
ISSN: 1472-684X
Titre abrégé: BMC Palliat Care
Pays: England
ID NLM: 101088685
Informations de publication
Date de publication:
29 Dec 2022
29 Dec 2022
Historique:
received:
15
06
2022
accepted:
06
12
2022
entrez:
29
12
2022
pubmed:
30
12
2022
medline:
3
1
2023
Statut:
epublish
Résumé
Due to the complexity of the provision of care for people with dementia, pain assessment and management is still considered to be lacking. An optimal way to support frontline staff in providing pain assessment and management for people with dementia living in nursing homes has not yet been identified. The success of supporting interventions seems dependent on contextual factors in the nursing homes. This study, therefore, analyzes the feasibility of a nurse-led training intervention, using repeated on-site case studies, in modifying pain intensity and frequency in people with dementia. Using a quasi-experimental design, we undertook a multi-center study of nurse-led training in pain management, with subsequent on-site case studies. Healthcare workers from 3 nursing homes assessed pain in 164 residents with dementia over 147 days. We used mixed-effect growth curve models with spline regression to analyze the data. We found that on-site case studies support frontline staff with pain management and assessment. Repeated reflection in case studies led to significantly longer pain free intervals (from 4.7 at baseline to 37.1 days at second follow-up) and decreased frequency of pain events (OR 0.54 at first follow-up and 0.43 at second follow-up). However no trends regarding pain intensity could be found. Therefore, on-site case studies may be valuable for improving pain frequency and pain-free intervals over time. This feasibility study shows the potential of on-site support for frontline nursing home staff. On-site case studies may also affect health outcomes in people with dementia. However, the complexity of dementia care necessitates the management of a broader range of needs. The study was retrospectively registered on the tenth of January 2017 with the German registry of clinical trials (DRKS00009726).
Sections du résumé
BACKGROUND
BACKGROUND
Due to the complexity of the provision of care for people with dementia, pain assessment and management is still considered to be lacking. An optimal way to support frontline staff in providing pain assessment and management for people with dementia living in nursing homes has not yet been identified. The success of supporting interventions seems dependent on contextual factors in the nursing homes. This study, therefore, analyzes the feasibility of a nurse-led training intervention, using repeated on-site case studies, in modifying pain intensity and frequency in people with dementia.
METHODS
METHODS
Using a quasi-experimental design, we undertook a multi-center study of nurse-led training in pain management, with subsequent on-site case studies. Healthcare workers from 3 nursing homes assessed pain in 164 residents with dementia over 147 days. We used mixed-effect growth curve models with spline regression to analyze the data.
RESULTS
RESULTS
We found that on-site case studies support frontline staff with pain management and assessment. Repeated reflection in case studies led to significantly longer pain free intervals (from 4.7 at baseline to 37.1 days at second follow-up) and decreased frequency of pain events (OR 0.54 at first follow-up and 0.43 at second follow-up). However no trends regarding pain intensity could be found. Therefore, on-site case studies may be valuable for improving pain frequency and pain-free intervals over time.
CONCLUSION
CONCLUSIONS
This feasibility study shows the potential of on-site support for frontline nursing home staff. On-site case studies may also affect health outcomes in people with dementia. However, the complexity of dementia care necessitates the management of a broader range of needs.
TRIAL REGISTRATION
BACKGROUND
The study was retrospectively registered on the tenth of January 2017 with the German registry of clinical trials (DRKS00009726).
Identifiants
pubmed: 36581883
doi: 10.1186/s12904-022-01118-9
pii: 10.1186/s12904-022-01118-9
pmc: PMC9798691
doi:
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
228Subventions
Organisme : Schweizerische Akademie der Medizinischen Wissenschaften
ID : 2015/14
Organisme : Stanley Thomas Johnson Stiftung,Switzerland
ID : 2015/14
Informations de copyright
© 2022. The Author(s).
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