Systematic pain assessment in nursing homes: a cluster-randomized trial using mixed-methods approach

Area of Science:

• Gerontology
• Nursing Science
• Pain Management

Background:

• Chronic pain significantly impacts nursing home residents' quality of life.
• Effective pain assessment is crucial for appropriate pain management strategies.
• Nursing home staff experiences with pain management interventions require investigation.

Purpose of the Study:

• To evaluate the effects of a structured pain management intervention on nursing home residents.
• To explore nursing staff perceptions and experiences regarding the pain management intervention.

Main Methods:

• A cluster-randomized trial with a mixed-methods approach was employed.
• The intervention group received systematic pain assessment training and support.
• Resident outcomes (wellbeing, pain, ADL-dependency) and nurse interviews were assessed.

Main Results:

• The intervention group showed no significant change in ADL-dependency, unlike the comparison group which increased.
• A notable proportion of residents in the intervention group experienced decreased or increased pain scores.
• No significant changes in medication use were observed; pain documentation remained sparse.

Conclusions:

• Systematic pain assessment in nursing homes enhances staff awareness and collaboration, potentially improving pain management.
• This approach may help maintain or improve residents' physical and functional abilities.
• The intervention did not significantly impact overall resident pain or wellbeing levels.