Pain Assessment and Management in Hospitalized Patients: A Review of Nursing and Healthcare Assistant Roles

Authors

  • Tahani Julayyil M Alanazi
  • Abdullah Awwadh Huyay Alrashidi
  • Tahani Almshne M Alanazi
  • Ghaidaa Fahad Aljabri
  • Albandri Hatab Ayed Alanazi
  • Hamdah Kawtim Alanazi
  • Basmah Muflih Z Alazmi
  • Mashael Faleh Alruwaili
  • Abeer Hattam R Alanazi
  • Hanan Khashm F Alruwaili
  • Majed Abdullah Khalaf Althomali

DOI:

https://doi.org/10.22399/ijcesen.4440

Keywords:

Pain assessment, pain management, hospitalized patients, nursing roles, healthcare assistants

Abstract

Effective pain assessment and management is crucial for improving patient outcomes and enhancing the overall healthcare experience in hospital settings. Nurses and healthcare assistants play pivotal roles in this process, employing various assessment tools to evaluate pain intensity, location, and quality. Utilizing standardized scales, such as the Numeric Rating Scale (NRS) or the Wong-Baker FACES Pain Rating Scale, these professionals can gather essential information to tailor interventions. Continuous monitoring and reassessment of pain are fundamental in the dynamic hospital environment, enabling healthcare teams to adjust treatment plans promptly and ensure adequate relief for patients. In addition to assessment, nurses and healthcare assistants are responsible for implementing and educating patients about pain management strategies. This may include administering prescribed analgesics, facilitating non-pharmacological techniques such as guided imagery or heat application, and supporting patients’ understanding of pain management options. Collaboration with interdisciplinary teams is vital, as it allows for comprehensive care plans that integrate pharmacological and non-pharmacological approaches to alleviate suffering. By fostering a patient-centered approach and advocating for patients' needs, nursing and healthcare assistant roles are integral in promoting effective pain management and improving the quality of care in hospitalized settings.

References

1. Hadjistavropoulos T, Herr K, Turk DC, Fine PG, Dworkin RH, Helme R, et al. An inter-disciplinary expert consensus statement on assessment of pain in older persons. The Clinical Journal of Pain. 2007;23(1):S1–S43.

2. Buffum MD, Hutt E, Chang VT, Craine MH, Snow AL. Cognitive impairment and pain management: review of issues and challenges. Journal of Rehabilitation Research and Development. 2007;44:315–330.

3. De Witt JB, Brazil K, Passmore A, Buchanan H, Maxwell D, McIlfatrick S, et al. “I don’t need a piece of paper with scores to tell me that somebody’s in pain and I need to do something about it”: Nurses’ and healthcare assistants’ perspectives on and use of pain assessment tools with people dying with advanced dementia. Palliative Medicine. 2016;30(6):NP45–NP46.

4. Lints-Martindale AC, Hadjistavropoulos T, Lix LM, Thorpe L. A comparative investigation of observational pain assessment tools for older adults with dementia. The Clinical Journal of Pain. 2012;28(3):226–237.

5. Burns M, McIlfatrick S. Palliative care in dementia: literature review of nurses’ knowledge and attitudes towards pain assessment. International Journal of Palliative Nursing. 2015;21(8):400–407.

6. Fisher S, Burgio L, Thorn B, Allen-Burge R, Gerstle J, Roth D, et al. Pain assessment and management in cognitively impaired nursing home residents: association of certified nursing assistant pain report, minimum data set pain report and analgesic report. Journal of the American Geriatrics Society. 2002;50(1):152–156.

7. Park J, Castellanos-Brown K, Belcher J. A review of observational pain scales in nonverbal elderly with cognitive impairments. Research on Social Work Practice. 2010;20(6):651–664.

8. Warden V, Hurley AC, Volicer L. Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) scale. Journal of the American Medical Directors Association. 2003;4(1):9–15.

9. Ruder S. Seven tools to assist hospice and home care clinicians in pain management at end of life. Home Healthcare Nurse. 2010;28(8):458–468.

10. Abbey J, Piller N, De Bellis A, Esterman A, Parker D, Giles L, et al. The Abbey pain scale: a 1-minute numerical indicator for people with end-stage dementia. International Journal of Palliative Nursing. 2004;10(1):6–13.

11. De Witt Jansen B, Brazil K, Passmore P, Buchanan H, Maxwell D, McIlfatrick SJ, et al. Nurses’ experiences of pain management for people with advanced dementia approaching the end of life: a qualitative study. Journal of Clinical Nursing. 2016.

12. Department of Health. Living well with dementia: a National Dementia Strategy. 2009.

13. Department of Health. The Cavendish Review: an independent review of healthcare assistants and support workers in NHS and social care settings. 2013.

14. DiCicco-Bloom B, Crabtree BF. The qualitative research interview. Medical Education. 2006;40(4):314–321.

15. van der Steen JT, Radbruch L, Hertogh CM, de Boer ME, Hughes JC, Larkin P, et al. White paper defining optimal palliative care in older people with dementia: a Delphi study and recommendations from the European Association for Palliative Care. Palliative Medicine. 2014;28(3):197–209.

16. De Witt Jansen B, Brazil K, Passmore A, Buchanan H, Maxwell D, McIlfatrick SJ, et al. “A tool doesn’t add anything”: Physicians’ perceptions and use of pain assessment tools with people with advanced dementia approaching the end of life. Palliative Medicine. 2016;30(6):NP3.

17. Morgan DG, Kosteniuk JG, O’Connell ME, Bello-Haas VD, Stewart NJ, Karunanayake C. Dementia-related work activities of home care nurses and aides: frequency, perceived competence, and continuing education priorities. Educational Gerontology. 2016;42(2):120–135.

18. Kessler I, Heron P, Dopson S, Magee H, Swain D, Ashkam J. The nature and consequences of support workers in a hospital setting. NHS Institute for Health Research; 2010.

19. De Witt Jansen B, Brazil K, Passmore P, Buchanan H, Maxwell D, McIlfatrick SJ, et al. “There’s a Catch-22”. The complexities of pain management for people with advanced dementia nearing the end of life: a qualitative exploration of physicians’ perspectives. Palliative Medicine. 2016.

20. Department of Health, Social Services and Public Safety. Improving dementia services in Northern Ireland: a regional strategy. 2011.

21. Ingleton C, Chatwin J, Seymour J, Payne S. The role of health care assistants in supporting district nurses and family carers to deliver palliative care at home: findings from an evaluation project. Journal of Clinical Nursing. 2011;20:2043–2052.

22. Klapwijk MS, Caljouw MAA, Van Soest-Poortvliet MC, van der Steen JT, Achterberg WP. Symptoms and treatment When death is expected in patient’s dementia in long-term care facilities. BMC Geriatrics. 2014;14:99.

23. Spilsbury K, Meyer J. Use, misuse and non-use of health care assistants: understanding the work of health care assistants in a hospital setting. Journal of Nursing Management. 2004;12(6):411–418.

24. Herr K, Coyne PJ, Key T, Manworren R, McCaffery M, Merkel S, et al. Pain assessment in the nonverbal patient: position statement with clinical practice recommendations. Pain Management Nursing. 2006;7(2):44–52.

25. Paulson CM, Monroe T, Mion LC. Pain assessment in hospitalized older adults with dementia and delirium. Journal of Gerontological Nursing. 2014;40(6):10–15.

26. American Geriatrics Society Panel on Persistent Pain in Older Persons. The management of persistent pain in older persons. Journal of the American Geriatrics Society. 2002;50(6 supplement):S205–S224.

27. Hendriks SA, Smalbrugge M, Galindo-Garre F, Hertogh CM, van der Steen JT. From admission to death: prevalence and course of pain, agitation, and shortness of breath, and treatment of these symptoms in nursing home residents with dementia. Journal of the American Medical Directors Association. 2015;16(6):475–481.

28. Mentes JC, Teer J, Cadogan MP. The pain experience of cognitively impaired nursing home residents: perceptions of family members and certified nursing assistants. Pain Management Nursing. 2004;5(3):118–125.

29. Jordan AI, Regnard C, Hughes JC. Hidden pain or hidden evidence? Journal of Pain and Symptom Management. 2007;33:658–660.

30. Ersek M, Herr K, Neradilek MB, Buck HG, Black B. Comparing the psychometric properties of the Checklist of Nonverbal Pain Behaviors (CNPI) and the Pain Assessment in Advanced Dementia (PAIN-AD) instruments. Pain Medicine. 2010;11(3):395–404.

31. Wilson CB, Davies S, Nolan M. Developing personal relationships in care homes: realising the contributions of staff, residents and family members. Ageing and Society. 2009;29:1041–1063.

32. Achterberg WP, Pieper MJC, van Dalen-Kok AH, de Waal MWM, Husebo BS, Lautenbacher S, et al. Pain management in patients with dementia. Clinical Interventions in Aging. 2013;8:1471–1482.

33. Husebo BS, Strand LI, Moe-Nilssen R, Borgehusebo S, Aarsland D, Ljunggren AE. Who suffers most? dementia and pain in nursing home patients: a cross-sectional study. Journal of the American Medical Directors Association. 2008;9(6):427–433.

34. World Health Organisation. World health statistics 2012.

35. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77–101.

36. Clark L, Jones K, Pennington K. Pain assessment practices with nursing home residents. Western Journal of Nursing Research. 2004;26(7):733–750.

37. Pasero C, McCaffery M. No self-report means no pain-intensity rating. The American Journal of Nursing. 2005;105(10):50–53.

38. Stacey CL. Finding dignity in dirty work: the constraints and rewards of low-wage home care labour. Sociology of Health & Illness. 2005;27(6):831–854.

39. Bunn F, Burn A-M, Goodman C, Rait G, Norton S, Robinson L, et al. Comorbidity and dementia: a scoping review of the literature. BMC Medicine. 2014;12:192.

40. Jordan A, Lloyd-Williams M. Distress and pain in dementia. In: Hughes JC, Lloyd-Williams M, Sachs GA, editors. Supportive care for the person with dementia. Oxford University Press: Oxford; 2010. pp. 129–137.

41. Lloyd JV, Schneider J, Scales K, Bailey S, Jones R. Ingroup identity as an obstacle to effective multiprofessional and interprofessional teamwork: findings from an ethnographic study of healthcare assistants in dementia care. Journal of Interprofessional Care. 2011;25:345–351.

Downloads

Published

2024-05-30

How to Cite

Tahani Julayyil M Alanazi, Abdullah Awwadh Huyay Alrashidi, Tahani Almshne M Alanazi, Ghaidaa Fahad Aljabri, Albandri Hatab Ayed Alanazi, Hamdah Kawtim Alanazi, … Majed Abdullah Khalaf Althomali. (2024). Pain Assessment and Management in Hospitalized Patients: A Review of Nursing and Healthcare Assistant Roles. International Journal of Computational and Experimental Science and Engineering, 10(4). https://doi.org/10.22399/ijcesen.4440

Issue

Section

Research Article