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dc.contributor.authorJansen, Bannin De Witt
dc.contributor.authorBrazil, Kevin
dc.contributor.authorPassmore, Peter
dc.contributor.authorBuchanan, Hilary
dc.contributor.authorMaxwell, Doreen
dc.contributor.authorMcIlfatrick, Sonja J
dc.contributor.authorMorgan, Sharon M
dc.contributor.authorWatson, Max
dc.contributor.authorParsons, Carole
dc.date.accessioned2017-03-03T11:22:24Z
dc.date.available2017-03-03T11:22:24Z
dc.date.issued2017-01-19
dc.identifier.citationExploring healthcare assistants' role and experience in pain assessment and management for people with advanced dementia towards the end of life: a qualitative study. 2017, 16 (1):6 BMC Palliat Careen
dc.identifier.issn1472-684X
dc.identifier.pmid28103847
dc.identifier.doi10.1186/s12904-017-0184-1
dc.identifier.urihttp://hdl.handle.net/10147/621113
dc.descriptionBACKGROUND: Pain assessment and management are key aspects in the care of people with dementia approaching the end of life but become challenging when patient self-report is impaired or unavailable. Best practice recommends the use of observational pain assessments for these patients; however, difficulties have been documented with health professionals' use of these tools in the absence of additional collateral patient knowledge. No studies have explored the role, perspectives and experiences of healthcare assistants in pain assessment and management in dementia; this study provides insight into this important area. METHODS: A qualitative approach was adopted, using key informant interviews with healthcare assistants caring for people with advanced dementia approaching the end of life in hospice, nursing home and acute care settings. Thematic analysis was the analytic approach taken to interpretation of interview data. Data were collected between June 2014 and September 2015. RESULTS: Fourteen participants took part in the study. Participants' average length of caring experience was 15.4 years and most were female. Three key themes emerged: recognising pain, reporting pain, and upskilling. Participants were often the first to notice obvious causes of pain and to detect changes in patient norms which signified hidden causes of pain. Comprehensive knowledge of resident norms enabled participants to observe for behavioural and nonverbal indicators of pain and distinguish these from non-pain related behaviours. Pain reporting was heavily impacted by relationships with professional staff and the extent to which participants felt valued in their role. Positive relationships resulted in comprehensive pain reports; negative relationships led to perfunctory or ambiguous reporting. Participants emphasised a desire for further training and upskilling, including in the use and reporting of basic pain tools. CONCLUSIONS: Healthcare assistants are frontline staff who have a key role in direct patient care, spending a considerable amount of time with patients in comparison to other health professionals. These staff are often first to notice changes in patients that may signify pain and to alert professional staff. However, to ensure the quality of these reports, further efforts must be made in reversing stigma attached to this role and in upskilling these members of the healthcare team.en
dc.description.abstractPain assessment and management are key aspects in the care of people with dementia approaching the end of life but become challenging when patient self-report is impaired or unavailable. Best practice recommends the use of observational pain assessments for these patients; however, difficulties have been documented with health professionals' use of these tools in the absence of additional collateral patient knowledge. No studies have explored the role, perspectives and experiences of healthcare assistants in pain assessment and management in dementia; this study provides insight into this important area.
dc.description.abstractA qualitative approach was adopted, using key informant interviews with healthcare assistants caring for people with advanced dementia approaching the end of life in hospice, nursing home and acute care settings. Thematic analysis was the analytic approach taken to interpretation of interview data. Data were collected between June 2014 and September 2015.
dc.description.abstractFourteen participants took part in the study. Participants' average length of caring experience was 15.4 years and most were female. Three key themes emerged: recognising pain, reporting pain, and upskilling. Participants were often the first to notice obvious causes of pain and to detect changes in patient norms which signified hidden causes of pain. Comprehensive knowledge of resident norms enabled participants to observe for behavioural and nonverbal indicators of pain and distinguish these from non-pain related behaviours. Pain reporting was heavily impacted by relationships with professional staff and the extent to which participants felt valued in their role. Positive relationships resulted in comprehensive pain reports; negative relationships led to perfunctory or ambiguous reporting. Participants emphasised a desire for further training and upskilling, including in the use and reporting of basic pain tools.
dc.description.abstractHealthcare assistants are frontline staff who have a key role in direct patient care, spending a considerable amount of time with patients in comparison to other health professionals. These staff are often first to notice changes in patients that may signify pain and to alert professional staff. However, to ensure the quality of these reports, further efforts must be made in reversing stigma attached to this role and in upskilling these members of the healthcare team.
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://download.springer.com/static/pdf/559/art%253A10.1186%252Fs12904-017-0184-1.pdf?originUrl=http%3A%2F%2Fbmcpalliatcare.biomedcentral.com%2Farticle%2F10.1186%2Fs12904-017-0184-1&token2=exp=1488450264~acl=%2Fstatic%2Fpdf%2F559%2Fart%25253A10.1186%25252Fs12904-017-0184-1.pdf*~hmac=af22203374a82ed5d3c14be1f9c4e94b7b0d1df38ca70ef56d48714afaa853c0en
dc.rightsArchived with thanks to BMC palliative careen
dc.subjectPALLIATIVE CAREen
dc.subjectPAIN MANAGEMENTen
dc.subjectDEMENTIAen
dc.subjectHEALTH CARE ASSISTANTSen
dc.subject.meshAdult
dc.subject.meshAllied Health Personnel
dc.subject.meshBehavior Observation Techniques
dc.subject.meshDementia
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshInservice Training
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshNorthern Ireland
dc.subject.meshPain
dc.subject.meshPain Measurement
dc.subject.meshProfessional Role
dc.subject.meshProfessional-Patient Relations
dc.subject.meshTerminal Care
dc.subject.meshYoung Adult
dc.subject.otherEND-OF-LIFE CAREen
dc.subject.otherMUSCULOSKELETAL CAREen
dc.titleExploring healthcare assistants' role and experience in pain assessment and management for people with advanced dementia towards the end of life: a qualitative study.en
dc.typeArticleen
dc.contributor.departmentOur Lady's Hospice & Care Servicesen
dc.identifier.journalBMC palliative careen
refterms.dateFOA2018-08-27T19:43:26Z
html.description.abstractPain assessment and management are key aspects in the care of people with dementia approaching the end of life but become challenging when patient self-report is impaired or unavailable. Best practice recommends the use of observational pain assessments for these patients; however, difficulties have been documented with health professionals' use of these tools in the absence of additional collateral patient knowledge. No studies have explored the role, perspectives and experiences of healthcare assistants in pain assessment and management in dementia; this study provides insight into this important area.
html.description.abstractA qualitative approach was adopted, using key informant interviews with healthcare assistants caring for people with advanced dementia approaching the end of life in hospice, nursing home and acute care settings. Thematic analysis was the analytic approach taken to interpretation of interview data. Data were collected between June 2014 and September 2015.
html.description.abstractFourteen participants took part in the study. Participants' average length of caring experience was 15.4 years and most were female. Three key themes emerged: recognising pain, reporting pain, and upskilling. Participants were often the first to notice obvious causes of pain and to detect changes in patient norms which signified hidden causes of pain. Comprehensive knowledge of resident norms enabled participants to observe for behavioural and nonverbal indicators of pain and distinguish these from non-pain related behaviours. Pain reporting was heavily impacted by relationships with professional staff and the extent to which participants felt valued in their role. Positive relationships resulted in comprehensive pain reports; negative relationships led to perfunctory or ambiguous reporting. Participants emphasised a desire for further training and upskilling, including in the use and reporting of basic pain tools.
html.description.abstractHealthcare assistants are frontline staff who have a key role in direct patient care, spending a considerable amount of time with patients in comparison to other health professionals. These staff are often first to notice changes in patients that may signify pain and to alert professional staff. However, to ensure the quality of these reports, further efforts must be made in reversing stigma attached to this role and in upskilling these members of the healthcare team.


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