Nurses' attitudes toward pain, pain assessment, and pain management practices in long-term care facilities.

This descriptive study was designed to identify attitudes regarding pain as well as pain assessment and management practices of nurses working with elderly residents in 10 long-term care facilities. Twenty-seven nurses from 10 facilities in the Midwest responded to a questionnaire. Findings indicate that more than half of the respondents reported that residents should be pain free; however, only 5 respondents defined pain free as no pain. Others defined it as being comfortable or able to perform activities of daily living. Nurses reported assessing the following aspects of pain more than three fourths of the time: onset, frequency, location, severity/intensity, facial expression, contortions, and medication effectiveness. Changes in weight, recreational activity, and concentration, as well as coping skills were assessed less than half of the time. When first learning residents were in pain, nurses reported doing further assessments, offering medication, giving emotional reassurance, and changing the resident's position. They reported substantial familiarity with basic nonpharmacologic practices but only asked residents to try these interventions (in addition to medication) an average of 38% of the time.