 Barriers to managing pain in the nursing home: findings from a statewide survey. OBJECTIVES: The objective of this study was to identify pain management demographics,
perceived resources, and perceived barriers to adequately manage pain in the
nursing home setting. DESIGN: Mailed survey. SETTING: All licensed Connecticut
nursing homes. PARTICIPANTS: Directors of Nursing (DONs). MEASUREMENTS: Survey
eliciting pain management demographics, perceived resources, and perceived barriers
to adequately manage pain in respondents' nursing home. RESULTS: A total of
113 of 260 DONs (43%) responded to the survey. Respondents believed pain was
suboptimally managed, particularly for residents with malignant and nonmalignant
chronic pain. Perceived barriers to providing adequate pain management included
lack of knowledge about pain management among nurses and physicians, lack of
a standardized approach to treating pain, physicians' personal attitudes toward
treating pain (eg, fear of addiction or overdose), lack of diagnostic precision
in treating pain, and difficulty in choosing the right analgesic. Other barriers
are also discussed, including low hospice enrollment of nursing home residents.
CONCLUSION: Improving pain management in nursing homes requires improving provider
knowledge and attitudes, enhancing diagnostic precision, standardizing pain
treatment, and achieving an institutional commitment. Although responding DONs
seemed aware of the need for improved pain management outcomes at their facilities,
the required institutional commitment to accomplish this was not evidenced by
these findings. Tarzian AJ, Hoffmann DE. J Am Med Dir Assoc. 2005 May-Jun;6(3
Suppl):S13-9. |
| Department of Pain Medicine and Palliative Care Beth Israel Medical Center, New York City ©2005 Continuum Health Partners, Inc. www.stoppain.org/palliative_care |
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