2 - Schools incorporating the Life Sciences and Medicine
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Item Assessment and management of pain in older adults with dementia : a review of current practice and future directions(Lippincott Williams & Wilkins, 2008-06) Schofield, PatPain in older adults has received increasing attention within the literature during the last decade, and in the past 12 months, there have been a number of papers published that highlight several key issues in the area. In terms of pharmacology and complementary therapies, there is still a need to evaluate their use in older adults in general. We have seen guidelines introduced and we need to consider how well these are being implemented. However, most importantly, we are now seeing increasing evidence supporting the use of three behavioural pain assessment scales, which look promising for the future.Item The assessment of pain in older people(Royal College of Physicians, 2007-10) Collett, B.; O'Mahoney, S.; Schofield, Pat; Closs, S.J.; Potter, J.Pain is under-recognised and under-treated in older people. It is a subjective, personal experience, only known to the person who suffers. The assessment of pain is particularly challenging in the presence of severe cognitive impairment, communication difficulties or language and cultural barriers. These guidelines set out the key components of assessing pain in older people, together with a variety of practical scales that may be used with different groups, including those with varying levels of cognitive or communication impairment. The purpose is to provide professionals with a set of practical skills to assess pain as the first step towards its effective management. The guidance has implications for all healthcare and social care staff and can be applied in all settings, including the older person’s own home, in care homes, and in hospital.Item Assessment of Pain in adults with cognitive impairment : a review of the tools(Freund, 2005-04) Schofield, Pat; Clarke, Amanda; Faulkner, Mark; Ryan, Tony; Dunham, Margaret; Howarth, AmandaThe aim of this paper is to discuss the results of a review into the literature related to chronic pain and the older adult. Several themes within the review have been identified and reported elsewhere and the final report has been published by the University of Sheffield in the form of an annotated bibliography. This report focuses upon the findings of the in relation to the assessment of pain in the adult with cognitive impairment. Issues surrounding assessment in the non-cognitively impaired older adult have also been reported elsewhere. For this paper nine studies will be discussed which report the development and testing of pain assessment scales the focus of which is upon behavioural indicators of pain. Some scales have been omitted from the review and the rationale for this decision will be discussed. Each of the selected scales will be discussed and the authors will make recommendations for both clinical practice and for future research based upon the validity, reliability and user friendliness of the scales. From the paper it can be concluded that the Abbey, DOLOPLUS-2 and PACSLAC appear to be the most reliable and valid and in terms of the “user friendliness” would be appropriate to explore further. Recommendations are made for further multi-centre evaluation of these scales.