2 - Schools incorporating the Life Sciences and Medicine
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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.Item Assessment of pain in older people : where are we now and what needs to be done?(Freund, 2006-01) Schofield, Pat; Clarke, Amanda; Faulkner, Mark; Ryan, Tony; Dunham, Margaret; Howarth, AmandaThe purpose of this paper is to present the findings of a review of the literature into pain and older people. The funded study was part of the development of an annotated bibliography published in August 2005. The review included all major databases and involved the collection of 214 papers between the dates of 1995 and 2005. The papers were divided into several major themes, which include experiences, management (pharmacological and non-pharmacological), assessment, and attitudes. Within this paper, the results of the review into pain assessment will be discussed, which includes 42 of the collected papers. The other sections will be published later. The paper will discuss issues pertaining to the development of specific tools for older people, a discussion of tools already available, comparisons of staff versus older people’s perceptions of pain scales, and articles with cognitive impairment as a focus. Recommendations for further study are made.Item The assessment and management of pain in older people : a systematic review of the literature(Freund, 2006-01) Schofield, Pat; Reid, David M.This paper presents the findings of a systematic literature which was carried out to determine the most appropriate strategies that could be carried out for the assessment and management of pain in residents living in care homes. Five hundred and seventy-one papers were initially identified and from this total 70 papers were found to be appropriate. These papers were organised into five key themes; Assessment & Behavioural Assessment, Barriers/Attitudes/Perceptions, Cognitive Behavioural Therapy, Complementary Therapies and Education/Guidelines. Most of the papers related to pain in this group were pharmacological suggesting that health care professionals generally feel that pharmacological approaches are the only way to manage pain in this group. Nevertheless, the non-pharmacological papers do suggest that there are other methods of pain control which should be considered. Recommendations for further research are made.