2.50
Hdl Handle:
http://hdl.handle.net/10755/157875
Type:
Presentation
Title:
Enhancing Caregiver Response to Pain During Morning Care
Abstract:
Enhancing Caregiver Response to Pain During Morning Care
Conference Sponsor:Western Institute of Nursing
Conference Year:2006
Author:Swafford, Kristen, MSN, RN
P.I. Institution Name:Oregon Health & Science University
Title:OHSU Student
Contact Address:23375 NE Ridge Rd, Gaston, OR, 97119, USA
Co-Authors:Lois Miller, PhD, RN; Joanne Rader, MS, RN; Karen Amann-Talerico, PhD, RN, CNS-BC; and Shirin Hiatt, MPH, RN
Conceptual Basis: A significant proportion of elders with moderate and advanced dementia have impaired ability to verbally communicate pain. It has been suggested that they communicate pain through behavioral symptoms, such as aggression and resisting care. These behavioral symptoms are viewed as self-protective mechanisms manifested in response to a perceived threat, such as pain. It is thought that behavioral symptoms will decrease if the threat is eliminated. In persons with advanced dementia, unrecognized and untreated pain is common and is frequently attributed to persistent musculoskeletal conditions. It is thought that movements associated with activities of morning care can exacerbate this pain. Because certified nursing assistants (CNAs) provide direct patient care in the nursing home setting, they are in a position to play an active role in recognizing and responding to persons with dementia who are experiencing pain. Purpose: In this paper, we present the clinical findings of a pilot study to develop the psychosocial component of an intervention called CARE (Comfort And Responsiveness Enhancement), aimed at reducing pain and resulting behavioral symptoms during morning care in nursing home residents with moderate and advanced dementia. Methods: The study was conducted in three nursing homes in the Pacific Northwest. Sixteen elders participated in the study, each with moderate or advanced dementia, behavioral symptoms, and documented medical sources of pain. Two nurse interventionists were paired with CNAs to develop, implement and revise individualized pain care plans for each participant. In this basic qualitative description, we used systematic content analyses of the care plans and interventionist's field notes using an iterative process throughout the intervention period and then again post intervention. Findings: The following categories of findings are presented and described: (a) enhancing CNA recognition of pain, (b) enhancing CNA response to pain, (c) caregiving strategies related to specific morning care activities, and (d) caregiving strategies related to movement, transfers, and positioning. Implications: These findings have practical and direct implications regarding the role of the CNA as an integral player in overall pain prevention. As direct supervisors of CNAs, nurses can contribute to patient comfort by supporting the CNA in implementing caregiving strategies that minimize pain. Grant acknowledgements: NIH, NRO5266-01; John A. Hartford BAGNC Scholars program.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEnhancing Caregiver Response to Pain During Morning Careen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157875-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Enhancing Caregiver Response to Pain During Morning Care</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Swafford, Kristen, MSN, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health &amp; Science University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">OHSU Student</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">23375 NE Ridge Rd, Gaston, OR, 97119, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">swaffork@ohsu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Lois Miller, PhD, RN; Joanne Rader, MS, RN; Karen Amann-Talerico, PhD, RN, CNS-BC; and Shirin Hiatt, MPH, RN</td></tr><tr><td colspan="2" class="item-abstract">Conceptual Basis: A significant proportion of elders with moderate and advanced dementia have impaired ability to verbally communicate pain. It has been suggested that they communicate pain through behavioral symptoms, such as aggression and resisting care. These behavioral symptoms are viewed as self-protective mechanisms manifested in response to a perceived threat, such as pain. It is thought that behavioral symptoms will decrease if the threat is eliminated. In persons with advanced dementia, unrecognized and untreated pain is common and is frequently attributed to persistent musculoskeletal conditions. It is thought that movements associated with activities of morning care can exacerbate this pain. Because certified nursing assistants (CNAs) provide direct patient care in the nursing home setting, they are in a position to play an active role in recognizing and responding to persons with dementia who are experiencing pain. Purpose: In this paper, we present the clinical findings of a pilot study to develop the psychosocial component of an intervention called CARE (Comfort And Responsiveness Enhancement), aimed at reducing pain and resulting behavioral symptoms during morning care in nursing home residents with moderate and advanced dementia. Methods: The study was conducted in three nursing homes in the Pacific Northwest. Sixteen elders participated in the study, each with moderate or advanced dementia, behavioral symptoms, and documented medical sources of pain. Two nurse interventionists were paired with CNAs to develop, implement and revise individualized pain care plans for each participant. In this basic qualitative description, we used systematic content analyses of the care plans and interventionist's field notes using an iterative process throughout the intervention period and then again post intervention. Findings: The following categories of findings are presented and described: (a) enhancing CNA recognition of pain, (b) enhancing CNA response to pain, (c) caregiving strategies related to specific morning care activities, and (d) caregiving strategies related to movement, transfers, and positioning. Implications: These findings have practical and direct implications regarding the role of the CNA as an integral player in overall pain prevention. As direct supervisors of CNAs, nurses can contribute to patient comfort by supporting the CNA in implementing caregiving strategies that minimize pain. Grant acknowledgements: NIH, NRO5266-01; John A. Hartford BAGNC Scholars program.</td></tr></table>en_GB
dc.date.available2011-10-26T20:17:20Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:17:20Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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