Nurses� Identification of Pain in Demented Patients in a Nursing Home: A Concept Analysis

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A major difficulty in assessing and managing pain in the presence of advanced dementia is the inability of these patients to self-report their experience of pain (Gabre &Sjoquist, 2002; Molony, Kobayashi, Holleran, & Mezey, 2005). Nevertheless, observational data from nursing home patients with advanced dementia and data from subjects with mild-to-moderate dementia suggest that dementia does not alter the fundamental experience of pain (Cohen-Mansfield&Lipson, 2002).However, patients with dementia are often unable to express pain adequately, recall a painful episode that may have occurred earlier, request analgesics, or operate patient controlled analgesia pumps (Morrison & Siu, 2000; Scherder et al., 2003).

Identifying and managing pain in in those with dementia is difficult. For individuals who have no ability to report pain, an outside observer must describe the discomfort by interpreting the patient's body language (Gabre & Sjoquist, 2002; Molony et al., 2005). A factor ...

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detect and manage the pain of patients with dementia, identifying pain in cognitive-impaired patients within nursing contexts should be explored. To identify in demented patients within nursing contexts, the following questions were addressed by the present study:

1. What are the characteristics of pain identification in demented patients within the nursing context?

2. What are the attributes of pain identification in demented patients by nurses?

3. What is the structure of pain identification in demented patients by nurses?

METHODS

Literature findings were used to develop concepts through a qualitative investigation of phenomena that occurred during participant ...

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