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The Diabetes Educator

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Western Journal of Nursing Research
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What's this?

Pain Management Decision Making Among Long-Term Care Physicians and Nurses

Sharon Kaasalainen

McMaster University, kaasal{at}mcmaster.ca

Esther Coker

Hamilton Health Sciences

Lisa Dolovich

McMaster University

Alexandra Papaioannou

McMaster University

Thomas Hadjistavropoulos

University of Regina

Anna Emili

Hamilton Health Sciences

Jenny Ploeg

McMaster University

The purpose of this study is to explore attitudes and beliefs that affect decisions about prescribing and administering pain medications in older adults who live in long-term care (LTC), with a particular emphasis on those with cognitive impairment. At each of the four participating LTC facilities, data were gathered from three separate groups of health care professionals: physicians, registered nurses, and registered practical nurses. Based on grounded theory, a model was developed that highlighted critical decision points for nurses and physicians regarding pain management. The major themes that emerged from the data concerned pain assessment (lack of recognition of pain, uncertainty about the accuracy of pain assessment and diagnosis) and treatment (reluctance to use opioids, working to individualize pain treatments, issues relating to physician trust of the nurse on prescribing patterns). These findings may facilitate the development of innovative approaches to pain management in LTC settings.

Key Words: pain management • older adults • dementia • long-term care • decision making

This version was published on August 1, 2007

Western Journal of Nursing Research, Vol. 29, No. 5, 561-580 (2007)
DOI: 10.1177/0193945906295522
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