Elderly pain assessment and pain management knowledge of long-term care nurses

The purpose of this study was to determine the knowledge base of long-term care nurses regarding pain assessment and management in the elderly. Three specific themes related to long-term care nurses were investigated: personal beliefs regarding patients' self-reports of pain, documentation of patients' self-reports of pain, and choice of pain medication and dose. Eighty-nine long-term care nurses, from 6 rural counties in California, responded to a questionnaire that consisted of 2 patient scenarios. The scenarios portrayed 1 patient as smiling and showing no objective signs of pain and the other patient as grimacing. Three questions followed up the scenarios related to elder pain assessment and management. Nurses were asked to indicate their pain assessment on a 0 to 10 scale and to choose the correct pain medication and dose. Frequencies and means were used to analyze demographic data; frequencies, t tests, and chi 2 testing compared nurse responses with the different questions. Results indicated that nurses were more likely to believe and document the grimacing patient's self-report of pain than the smiling patient. Older nurses with more experience were less likely to believe or document their patient's self-report of pain than younger nurses with fewer years of experience. Less than half of the nurses would increase the analgesic dose for either patient scenario. Nursing implications include the importance of ongoing pain assessment and management education tailored to the geriatric population and long-term care.