Simen Alexander Steindal1,2, Inger Schou Bredal3, Anette Hylen Ranhoff4,5, Liv Wergeland Sørbye1, Anners Lerdal6,7. 1. Institute of Nursing and Health, Diakonhjemmet University College, Oslo, Norway. 2. Palliative Care Unit, Department of Oncology, Oslo University Hospital, Oslo, Norway. 3. Surgery and Transplantation Department, Faculty of Medicine, University of Oslo and Cancer, Oslo University Hospital, Ullevål, Oslo, Norway. 4. Medical Department, Diakonhjemmet Hospital, Oslo, Norway. 5. Department of Clinical Science, University of Bergen, Bergen, Norway. 6. Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway. 7. Deptartment of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
Abstract
BACKGROUND: Pain is a common symptom in older patients at the end of life. Little research has evaluated pain management among the oldest hospitalised dying patients. AIMS AND OBJECTIVES: To compare the pain characteristics documented by healthcare workers for the young old and the oldest old hospitalised patients and the types of analgesics administered in the last three days of life. DESIGN: A retrospective cross-sectional comparative study. METHODS: The study included 190 patients from a Norwegian general hospital: 101 young old patients (aged 65-84 years) and 89 oldest old patients (aged 85-100 years). Data were extracted from electronic patient records (EPRs) using the Resident Assessment Instrument for Palliative Care. RESULTS: No significant differences were found between the young old and the oldest old patients with regard to pain characteristics. Pain intensity was poorly recorded in the EPRs. Most of the patients received adequate pain control. Morphine was the most frequently administered analgesic for dying patients. Compared to the oldest old patients, a greater proportion of the young old patients received paracetamol combined with codeine (OR = 3.25, 95% CI 1.02-10.40). CONCLUSIONS: There appeared to be no differences in healthcare workers' documentation of pain characteristics in young old and oldest old patients, but young old patients were more likely to receive paracetamol in combination with codeine. IMPLICATIONS FOR PRACTICE: A limitation of the study is the retrospective design and that data were collected from a single hospital. Therefore, caution should be taken for interpretation of the results. The use of systematic patient-reported assessments in combination with feasible validated tools could contribute to more comprehensive documentation of pain intensity and improved pain control.
BACKGROUND:Pain is a common symptom in older patients at the end of life. Little research has evaluated pain management among the oldest hospitalised dying patients. AIMS AND OBJECTIVES: To compare the pain characteristics documented by healthcare workers for the young old and the oldest old hospitalised patients and the types of analgesics administered in the last three days of life. DESIGN: A retrospective cross-sectional comparative study. METHODS: The study included 190 patients from a Norwegian general hospital: 101 young old patients (aged 65-84 years) and 89 oldest old patients (aged 85-100 years). Data were extracted from electronic patient records (EPRs) using the Resident Assessment Instrument for Palliative Care. RESULTS: No significant differences were found between the young old and the oldest old patients with regard to pain characteristics. Pain intensity was poorly recorded in the EPRs. Most of the patients received adequate pain control. Morphine was the most frequently administered analgesic for dying patients. Compared to the oldest old patients, a greater proportion of the young old patients received paracetamol combined with codeine (OR = 3.25, 95% CI 1.02-10.40). CONCLUSIONS: There appeared to be no differences in healthcare workers' documentation of pain characteristics in young old and oldest old patients, but young old patients were more likely to receive paracetamol in combination with codeine. IMPLICATIONS FOR PRACTICE: A limitation of the study is the retrospective design and that data were collected from a single hospital. Therefore, caution should be taken for interpretation of the results. The use of systematic patient-reported assessments in combination with feasible validated tools could contribute to more comprehensive documentation of pain intensity and improved pain control.
Authors: Sebastiano Mercadante; Federica Aielli; Francesco Masedu; Marco Valenti; Lucilla Verna; Giampiero Porzio Journal: Support Care Cancer Date: 2015-10-16 Impact factor: 3.603
Authors: Linda Pang; Maxine de la Cruz; Jimin Wu; Diane Liu; Mujtaba Naqvi; Eduardo Bruera Journal: Support Care Cancer Date: 2019-02-23 Impact factor: 3.603