Pain management decision making among long-term care physicians and nurses

Area of Science:

• Gerontology
• Pain Management
• Healthcare Professional Attitudes

Background:

• Effective pain management in older adults, particularly those in long-term care (LTC), is crucial.
• Cognitive impairment in this population presents unique challenges for pain assessment and treatment.
• Understanding healthcare provider beliefs is essential for optimizing pain medication practices.

Purpose of the Study:

• To explore the attitudes and beliefs influencing pain medication decisions in older adults within LTC settings.
• To specifically examine these factors in residents with cognitive impairment.
• To identify critical decision points for healthcare professionals in pain management.

Main Methods:

• Grounded theory approach used for data analysis.
• Data collected from physicians, registered nurses, and registered practical nurses at four LTC facilities.
• Focus on understanding decision-making processes regarding pain assessment and medication administration.

Main Results:

• Identified key themes in pain assessment, including lack of recognition and diagnostic uncertainty.
• Revealed reluctance in using opioid analgesics and issues with physician trust in nurse prescribing.
• Highlighted efforts to individualize pain treatment plans for residents.
• Developed a model of critical decision points for pain management.

Conclusions:

• Healthcare professionals' beliefs significantly impact pain management for LTC residents.
• Addressing uncertainty in pain assessment and reluctance towards opioids is necessary.
• Improving physician-nurse trust can enhance prescribing patterns and individualized pain care.
• Findings can inform innovative strategies for better pain control in long-term care.