scholarly journals Nurses' experiences of pain management in end-of-life dementia care: a literature review

2020 ◽  
Vol 26 (3) ◽  
pp. 110-118
Author(s):  
Kerry May ◽  
Janet Scammell
Keyword(s):  
Pain Management ◽  
End Of Life ◽  
Qualitative Methodology ◽  
Assessment Tool ◽  
Care Delivery ◽  
Dementia Care ◽  
Assessment Tools ◽  
Client Group ◽  
People With Dementia ◽  
Pain Recognition

Background: Nurses play an important role in assessing and managing pain. However, this is often poorly managed for people living with dementia. Aim: To explore nurses' experiences of pain management in end-of-life dementia care. Methods: Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a systematic narrative review of research papers published in English between 2008 and 2018 was conducted. Data sources were CINAHL, Medline, PsycINFO, ScienceDirect and SocIndex. Articles focused on nursing at the end of life and pain management in people with dementia. Findings: Eight articles were retrieved that met the search criteria. Four studies used qualitative methodology, two quantitative and two mixed methods. Studies from the UK dominated (n=5), the remainder were from Sweden, Norway and the US. Following thematic analysis, three themes were identified: training and education in pain management at the end of life for people with dementia, challenges in identifying pain and pain assessment tool use. Conclusion: The review revealed inadequate education for nurses concerning end-of-life care for people living with dementia, notably concerning pain recognition and use of assessment tools. It is recommended that specialist education is mandated for all nurses working with this client group to improve care delivery.

scholarly journals Cognitive and functional dementia assessment tools: Review of Brazilian literature

2007 ◽  
Vol 1 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Luciano Góis Vasconcelos ◽  
Sonia Maria Dozzi Brucki ◽  
Orlando Francisco Amodeo Bueno
Keyword(s):  
Normative Data ◽  
Formal Education ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Functional Evaluation ◽  
Brazilian Literature ◽  
Assessment Tests ◽  
People With Dementia ◽  
Diagnosis Of Dementia ◽  
Independent Effects

Abstract The diagnosis of dementia is based on cognitive and functional evaluation. One of the difficulties in ascertaining the number of people with dementia in developing countries is the population's lack of formal education. Independent effects of age, sex and education have been identified on scores for most but not all cognitive tests. Objectives: Identify the most-used cognitive and functional assessment tools in Brazil, related to dementia diagnosis and treatment outcome; and identify adaptations or normative data, when available. Methods: Data were generated from PubMed, LILACS and Portal Periodicos CAPES (thesis database) databases using the search terms 'dementia' and 'Alzheimer'. Data collection criteria were a. Articles with abstract; b. Brazilian abstracts, related to adult Brazilian population; c. Clear mention of assessment tool in the abstract text. A total of 108 abstracts were selected for the main analysis: a. to identify the instruments used b. to determine how many of the selected abstracts mentioned each tool and c. to search in the mentioned databases for respective test adaptations or normative data. Results: Some 52 different assessment tools, 41 cognitive instruments and 11 functional instruments were identified. The most cited assessment tests were the Mini Mental State Examination (64 abstracts) and Pfeffer Functional Activities Questionnaire (4 abstract). Discussion: Many of the instruments used only have the description of the translation process into Portuguese, along with some suggestions of validation or normative data. Few of these followed the recommended procedures of validation, replication, normalization or transcultural adaptation.

scholarly journals Assessment of pain in people living with dementia at the end of life: a systematic review

2021 ◽  
Vol 27 (2) ◽  
pp. 72-85
Author(s):  
Grainne McAnee ◽  
Kelly Norwood ◽  
Michael Rosato ◽  
Gerry Leavey
Keyword(s):  
Systematic Review ◽  
End Of Life ◽  
Web Of Science ◽  
Assessment Tools ◽  
Robust Approach ◽  
People With Dementia ◽  
Formal Tool ◽  
Ebsco Host ◽  
Quality Of Research

Background: People with dementia may not receive the same quality of palliative care as those with other life-limiting conditions, particularly at end of life (EoL). Aims: To understand the best way to examine pain in people with dementia. Methods: A systematic review of tools to assess pain in patients with dementia near the end of life; PubMed, Medline, Embase, EBSCO Host, CINAHL Plus, Web of Science, Psycinfo, PsycArticles and Scopus were searched. Findings: A total of 15 articles were identified, which were qualitatively synthesised. Conclusion: There are a range of pain assessment tools that are appropriate for use in people with dementia, but all 15 studies used a formal tool. A more robust approach is needed to improve the quality of research for measurement and management of pain in this population.

scholarly journals Frailty assessment and acute frailty service provision in the UK: results of a national ‘day of care’ survey

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Thomas Knight ◽  
Catherine Atkin ◽  
Finbarr C Martin ◽  
Chris Subbe ◽  
Mark Holland ◽  
...  
Keyword(s):  
Acute Care ◽  
Assessment Tool ◽  
Care Delivery ◽  
Care Pathway ◽  
National Policy ◽  
Assessment Tools ◽  
Screening Policy ◽  
Frailty Assessment ◽  
Care Survey ◽  
The Uk

Abstract Background The incorporation of acute frailty services into the acute care pathway is increasingly common. The prevalence and impact of acute frailty services in the UK are currently unclear. Methods The Society for Acute Medicine Benchmarking Audit (SAMBA) is a day of care survey undertaken annually within the UK. SAMBA 2019 (SAMBA19) took place on Thursday 27th June 2019. A questionnaire was used to collect hospital and patient-level data on the structure and organisation of acute care delivery. SAMBA19 sought to establish the frequency of frailty assessment tool use and describe acute frailty services nationally. Hospitals were classified based on the presence of acute frailty services and metrics of performance compared. Results A total of 3218 patients aged ≥70 admitted to 129 hospitals were recorded in SAMBA19. The use of frailty assessment tools was reported in 80 (62.0%) hospitals. The proportion of patients assessed for the presence of frailty in individual hospitals ranged from 2.2 to 100%. Bedded Acute Frailty Units were reported in 65 (50.3%) hospitals. There was significant variation in admission rates between hospitals. This was not explained by the presence of a frailty screening policy or presence of a dedicated frailty unit. Conclusion Two fifths of participating UK hospitals did not have a routine frailty screening policy: where this existed, rates of assessment for frailty were variable and most at-risk patients were not assessed. Responses to positive results were poorly defined. The provision of acute frailty services is variable throughout the UK. Improvement is needed for the aspirations of national policy to be fully realised.

scholarly journals The practice and ethics of dementia care

2015 ◽  
Vol 27 (10) ◽  
pp. 1579-1581
Author(s):  
Henry Brodaty
Keyword(s):  
Quality Of Life ◽  
Service Delivery ◽  
End Of Life ◽  
Family Caregivers ◽  
Dementia Care ◽  
Policy Makers ◽  
People With Dementia ◽  
Dementia Research

The focus in dementia research on discovery of cause and cure often leaves the care part of the triad hidden from the spotlight. While clinicians, caregivers, and policy makers eagerly await these scientific developments, daily they face challenges in striving best for quality of life for people with dementia and their family caregivers. This issue of the Journal addresses six topics: three relate to service delivery – at assessment, in the community and at end of life; and one each focus on ethics, driving and suicidality.

Assessing capacity to consent to treatment with cholinesterase inhibitors in dementia using a specific and standardized version of the MacArthur Competence Assessment Tool (MacCAT-T)

2016 ◽  
Vol 29 (2) ◽  
pp. 333-343 ◽  
Author(s):  
Tanja Mueller ◽  
Julia Haberstroh ◽  
Maren Knebel ◽  
Frank Oswald ◽  
Roman Kaspar ◽  
...  
Keyword(s):  
Informed Consent ◽  
Cholinesterase Inhibitors ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Competence Assessment ◽  
Rater Reliability ◽  
Capacity To Consent ◽  
People With Dementia ◽  
Hypothetical Treatment ◽  
Consent To Treatment

ABSTRACTBackground:The use of assessment tools has been shown to improve the inter-rater reliability of capacity assessments. However, instrument-based capacity assessments of people with dementia face challenges. In dementia research, measuring capacity with instruments like the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) mostly employ hypothetical treatment vignettes that can overwhelm the abstraction capabilities of people with dementia and are thus not always suitable for this target group. The primary aim of this study was to provide a standardized real informed consent paradigm that enables the dementia-specific properties of capacity to consent to treatment in people with dementia to be identified in a real informed consent process that is both externally valid and ethically justifiable.Methods:The sample consisted of 53 people with mild to moderate dementia and a group of 133 people without cognitive impairment. Rather than using a hypothetical treatment vignette, we used a standardized version of the MacCAT-T to assess capacity to consent to treatment with cholinesterase inhibitors in people with dementia. Inter-rater reliability, item statistics, and psychometric properties were also investigated.Results:Intraclass correlations (ICCs) (0.951–0.990) indicated high inter-rater reliability of the standardized real informed consent paradigm. In the dementia group, performance on different items of the MacCAT-T varied. Most people with dementia were able to express a treatment choice, and were aware of the need to take a tablet. Further information on the course of the disorder and the benefits and risks of the treatment were less understood, as was comparative reasoning regarding treatment alternatives.Conclusion:The standardized real informed consent paradigm enabled us to detect dementia-specific characteristics of patients’ capacity to consent to treatment with cholinesterase inhibitors. In order to determine suitable enhanced consent procedures for this treatment, we recommend the consideration of MacCAT-T results on an item level. People with dementia seem to understand only basic information. Our data indicate that one useful strategy to enhance capacity to consent is to reduce attention and memory demands as far as possible.

CRIES: A Neonatal Postoperative Pain Measurement Score

2018 ◽  
pp. 263-267
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Pain Assessment ◽  
Reliable Method ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Neonatal Pain ◽  
Reliable Assessment ◽  
Assessment And Treatment ◽  
Neonatal Population

This case focuses on neonatal pain management by asking the question: Is the CRIES score a valid and reliable method for assessing neonatal postoperative pain? Regular pain assessment and treatment in the neonatal population are important postoperatively. The CRIES scale was designed to measure pain in the neonatal population, and this study demonstrated CRIES to be a valid and reliable assessment tool for identifying postsurgical pain in neonates. Multiple pain assessment tools, including CRIES, are available for use in neonatal patients and in patient populations who are otherwise unable to verbalize discomfort.

scholarly journals Assessing collaborative performance on construction projects through knowledge exchange

2017 ◽  
Vol 24 (6) ◽  
pp. 968-987 ◽  
Author(s):  
Gergana Staykova ◽  
Jason Underwood
Keyword(s):  
Construction Projects ◽  
Qualitative Methodology ◽  
Assessment Tool ◽  
Single Case ◽  
Knowledge Exchange ◽  
Assessment Tools ◽  
Continuous Assessment ◽  
Structured Interviews ◽  
Content Type ◽  
Collaborative Performance

Purpose How knowledge exchange (KE) can be used for the continuous assessment and improvement of collaborative performance of project-based organisations in construction is explored. Collaboration on construction projects must be facilitated by people alongside practice of continuous performance assessment and improvement. Currently available assessment tools fail to explicitly define appropriate behaviours and actions due to a poor understanding of what it means for people to collaborate. In contrast, it is established that KE is the focus of collaborative efforts on construction projects; therefore, as most knowledge resides with people, it represents their role in collaboration. The paper aims to discuss these issues. Design/methodology/approach Through a phenomenological/interpretivist and qualitative methodology, how KE can be used for the continuous assessment and improvement of collaborative performance in project-based organisations in construction is explored. A single case study of a UK rail strategic alliance was adopted and six semi-structured interviews were conducted and analysed through a thematic analysis. Findings An assessment tool is proposed based on a set of 20 characteristics of KE, divided into seven categories and linked to indicators of collaboration. The tool can be applied to highly collaborative projects where BIM and Lean are implemented, and project participants are collocated. By measuring their performance against the set criteria, project teams can assess which of their behaviours and actions are inappropriate, and focus their efforts on correcting them. Originality/value Defining the abstract indicators traditionally used to assess collaboration in terms of characteristics pertinent to day-to-day communication amongst participants on collaborative projects to facilitate the continuous assessment and improvement of collaborative performance.

scholarly journals Advance care planning for people with dementia: Ordinary everyday conversations

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 3023-3035 ◽  
Author(s):  
Kay de Vries ◽  
Jenny Drury-Ruddlesden
Keyword(s):  
End Of Life ◽  
Family Member ◽  
Advance Care Planning ◽  
Planning Process ◽  
Developed Countries ◽  
Dementia Care ◽  
Care Planning ◽  
People With Dementia ◽  
Advance Care ◽  
Person With Dementia

Advance care planning for people with dementia has become a focus of dementia care policies in developed countries. In New Zealand, the framework for dementia care relies on the person with dementia having a level of competence to enable them to participate in the planning process. For people with dementia, it may be too late to initiate these discussions in terms of decision-making capacity. Consequently, decisions about end-of-life care for people with dementia are typically made by a family member who acts as a surrogate decision maker on behalf of the person with dementia. An exploratory qualitative study of 23 people who had been carers or provided support for a family member with dementia who had died within five years of the interview was undertaken. The overarching theme, ‘ordinary everyday conversations’, describes how informal conversations and discussions within the family relating to preferences at the end of life had been embedded in interactions within the families over years. Sub-themes revealed three important components enabling adherence to the prior wishes of the person with dementia through these conversations: knowing the person and belief in ‘doing the right thing’; the importance of Wills and Enduring Power of Attorney; and negotiating unexpected encounters. There is potential for families to be well prepared for the time when they may need to make decisions for the person with dementia based on ordinary everyday conversation that take place within families and throughout life. This study also suggests that more innovative approaches to making a Will may provide an important vehicle for expressing advanced care wishes.

scholarly journals Identifying Spanish Language Competent Physicians: The Diabetes Study of Northern California (DISTANCE)

2016 ◽  
Vol 26 (4) ◽  
pp. 537 ◽  
Author(s):  
Claudia Chaufan ◽  
Andrew J. Karter ◽  
Howard H. Moffet ◽  
Judy Quan ◽  
Melissa M. Parker ◽  
...  
Keyword(s):  
Health Care ◽  
Assessment Tool ◽  
Care Delivery ◽  
Low Cost ◽  
Weighted Kappa ◽  
Spanish Language ◽  
Assessment Tools ◽  
Self Assessment ◽  
Language Competence ◽  
Patient Reported

<p class="Pa7"><strong>Objectives: </strong>Language barriers negatively impact health care access and quality for US immigrants. Latinos are the second largest immigrant group and the largest, fastest growing minority. Health care systems need simple, low cost and accurate tools that they can use to identify physicians with Spanish language competence. We sought to address this need by validating a simple and low-cost tool already in use in a major health plan.</p><p class="Pa7"><strong>Design, Setting, Participants: </strong>A web-based survey conducted in 2012 among physicians caring for patients in a large, integrated health care delivery system. Of the 2,198 survey respondents, 111 were used in ad­ditional analysis involving patient report of those physicians’ fluency.</p><p class="Pa7"><strong>Main Outcome Measures: </strong>We compared health care physicians’ responses to a single item, Spanish language self-assessment tool (measuring “medical proficiency”) with patient-reported physician language competence, and two validated physician self-assessment tools (measuring “fluency” and “confidence”).</p><p class="Pa7"><strong>Results: </strong>Concordance between medical proficiency was moderate with patient reports (weighted Kappa .45), substantial with fluency (weighted Kappa .76), and moderate-to-substantial with confidence (weighted Kappas .53 to .66).</p><p class="Pa7"><strong>Conclusions: </strong>The single-question self-re­ported medical proficiency tool is a low-cost tool useful for quickly identifying Spanish competent physicians and is potentially suit­able for use in clinical settings. A reasonable approach for health systems is to designate only those physicians who self-assess their Spanish medical proficiency as “high” as competent to provide care without an interpreter.</p><p class="Pa7"><em>Ethn Dis. </em>2016;26(4):537-544; doi:10.18865/ed.26.4.537</p><strong></strong>

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