Barra laterale dell'articolo

Scarica
Abbonamento o quota di accesso PDF (EUR 5)
Statistica
Leggi contatore : 1364 Scarica : 36

Contenuto dell'articolo principale

Abstract

Introduzione. Il dolore è uno dei problemi più frequenti nelle persone anziane istituzionalizzate con decadimento cognitivo. Questo sintomo è spesso sottovalutato e sottostimato. L'utilizzo delle scale di accertamento auto-compilate è generalmente la metodica più consona anche nei soggetti con lieve-moderata demenza. La letteratura dispone di numerose scale unidimensionali auto-compilate, ma i risultati degli studi portano a conclusioni considerevolmente diverse nel raccomandare la scala più appropriata. Scopo. Il presente lavoro ha la finalití  di comparare tre scale unidimensionali per accertare il dolore negli anziani residenti in due case di riposo.

Metodo. Sono stati reclutati 84 anziani con punteggio medio al Mini-Mental State Examination pari a 18. Il dolore è stato valutato somministrando consecutivamente le scale Faces Pain Scale (FPS), Numeric Rating Scale (NRS), Verbal Rating Scale (VRS). La raccolta dati è stata fatta da un professionista non dipendente delle due case di riposo, con pregressa idonea formazione all'uso delle scale.

Risultati. I risultati mostrano che la prevalenza di dolore è tra il 60-70%. L'accordo tra le scale è risultato elevato ed altamente significativo (p=0,0001) anche se il tempo di compilazione della Faces Pain Scale è sensibilmente superiore alle altre due (p=0,0001).

Conclusione. I risultati suggeriscono l'implementazione di queste scale nei vari protocolli operativi considerando il tempo di compilazione e le preferenze dei pazienti.

Parole chiave: anziano, demenza, misurazione del dolore, prevalenza.


Unidimensional scales for dementia: a cross-sectional study in elderly Italian retirement houses residents

Background. The pain in instituzionalized elderly people with cognitive impairment is common. This symptom is severely under-reported and under-treated within this population. Evaluation of pain intensity is an essential component of pain assessment. Self-report approach to pain assessment is generally regarded as the gold standard of pain measurement in people with mild and moderate cognitive decay. The literature demonstrated more different unidimensional self-report scales but the conclusions of the studies suggested often the utilization of different scales.

Aim. The goal of this study was to compare three different unidimensional pain assessment scales to be used with 84 instituzionalized elderly people with an average Mini-Mental State Examination score of 18. Method. This was a descriptive cross-sectional study. The pain assessment was carried out by administering the three scales Faces Pain Scale (FPS), Numeric Rating Scale (NRS), Verbal Rating Scale (VRS).

Results. The results showed that the prevalence of pain was 60-70%. All three pain intensity scales had good reliability and validity (p=0.0001); The compilation time of Faces Pain Scale most above than the other two scales (p=0.0001).

Conclusion. The findings of this article support the implementation of these scales in operative protocols considering the compilation time and preferences of the patients.

Key words: aged, dementia, pain measurement, prevalence.

Dettagli dell'articolo

Come citare
Storti, M., & Giantin, V. (2017). Valutazione del dolore in soggetti con deterioramento cognitivo lieve-moderato: uno studio trasversale su anziani italiani istituzionalizzati. PROFESSIONI INFERMIERISTICHE, 70(3). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/426
Scarica citazione
Endnote/Zotero/Mendeley (RIS)
BibTeX

Riferimenti

  • Batsch, N.L., & Mittelman, M.S. (2012). World Alzheimer Report 2012. Overcoming the Stigma of Dementia. London: Alzheimer's Disease International (ADI).
  • Bauer, U., Pitzer, S., Schreier, M.M., Osterbrink, J., Alzner, R., & Iglseder, B. (2016). Pain treatment for nursing home residents differs according to cognitive state - a cross-sectional study. BMC Geriatrics, 16 (1), 124.
  • Bjoro, K., & Herr, K. (2008). Assessment of pain in the nonverbal or cognitive impaired older adult. Clinics in Geriatric Medicine, 24 (2), 237-262.
  • Boerlage, A., van Dijk, M.D., de Wit, R., & van der Rijt, C.C. (2008). Pain prevalence and characteristics in three Dutch residential homes. European Journal of Pain, 12 (7), 910-916.
  • Castro-Monteiro, E., Alhayek-Aí­, M., Diaz-Redondo, A., Ayala, A., Rodriguez-Blazquez, C., Rojo-Perez, F., Martinez-Martin, P., & Forjaz, M.J. (2016). Quality of life of institutionalized older adults by dementia severity. International Psychogeriatrics, 28 (1), 83-92.
  • Closs, S.J., Barr, B., Briggs, M., Cash, K., & Seers, K. (2014). A comparison of five pain assessment scales for nursing home residents with varying degrees of cognitive impairment. Journal of Pain and Symptom Management, 27 (3), 196-205.
  • Cordner, Z., Blass, D.M., Rabins, P.V., & Black, B.S. (2010). Quality of life in nursing home residents with advanced dementia. Journal of the American Geriatrics Society, 58 (12), 2394-2400.
  • Cunningham, C., McClean, W., & Kelly, F. (2010). The assessment and management of pain in people with dementia in care homes. Nursing Older People, 22 (7), 29-35.
  • Damiani, G., Colosimo, S.C., Sicuro, L., Burgio, A., Battisti. A., Solipaca, A., Baldassarre, G., Crialesi, R., Milan, G., Tamburrano, T., & Ricciardi, W. (2009). An ecological study on the relationship between supply of beds in long-term care institutions in Italy and potential care needs for the elderly. BMC Health Services Research, 24(9), 174.
  • D'Astolfo, C.J., & Humphreys, B.K. (2006). A record review of reported musculoskeletal pain in an Ontario long term care facility. BMC Geriatrics, 23 (6), 5.
  • De Conno, F., Caraceni, A., Gamba, A., Mariani, L., Abbattista, A., Brunelli, C., La Mura, A., & Ventafridda, V. (1994). Pain measurement in cancer patients: a comparison of six methods. Pain, 57 (2), 161-166.
  • Elseviers, M.M., Vander Stichele, R.R., & Van Bortel, L. (2010). Drug utilization in Belgian nursing homes: impact of residents' and institutional characteristics. Pharmacoepidemiology and Drug Safety, 19 (10), 1041-1048.
  • Ferrell, B.A. (1995). Pain evaluation and management in the nursing home. Annals of Internal Medicine, 123 (9), 681-687.
  • Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12 (3), 189-198.
  • Gallasch, C.H., & Alexandre, N.M.C. (2012). The measurement of musculoskeletal pain intensity: a comparison of four methods. Revista Gaucha de Enfermagem, 28 (2), 260-265.
  • Giebel. C., Sutcliffe, C., Verbeek, H., Zabalegui, A., Soto, M., Hallberg, I.R., Saks, K., Renom-Guiteras, A., Suhonen, R., & Challis, D. (2016). Depressive symptomatology and associated factors in dementia in Europe: home care versus long-term care. International Psychogeriatrics, 28 (4), 621-630.
  • Gracely, R.H., & Dubner, R. (1987). Reliability and validity of verbal descriptor scales of painfulness. Pain, 29 (2), 175-185.
  • Gregory, J. (2015). The complexity of pain assessment in older people. Nursing Older People, 27 (8), 16-21.
  • Hadjistavropoulos, T., Herr, K., Turk, D.C., Fine, P.G., Dworkin, R.H., Helme, R., Jackson, K., Parmelee, P.A., Rudy, T.E., Lynn Beattie, B., Chibnall, J.T., Craig, K.D., Ferrell, B., Fillingim, R.B., Gagliese, L., Gallagher, R., Gibson, S.J., Harrison, E.L., Katz, B., Keefe, F.J., Lieber, S.J., Lussier, D., Schmader, K.E., Tait, R.C., Weiner, D.K., & Williams, J. (2007). An interdisciplinary expert consensus statement on assessment of pain in older persons. The Clinical Journal of Pain, 23 (1), 1-43.
  • Herr, K. (2011). Pain assessment strategies in older patients. The Journal of Pain, 12 (1), 3-13.
  • Herr, K.A., Spratt, K., Mobily, P.R, & Richardson, G. (2004). Pain intensity assessment in older adults: use of experimental pain compare psychometric properties and usability of selected pain scales with younger adults. The Clinical Journal of Pain, 20 (4), 207-219.
  • Hidaka, S., Ikejima, C., Kodama, C., Nose, M., Yamashita, F., Sasaki, M., Kinoshita, T., Tanimukai, S., Mizukami, K., Takahashi, H., Kakuma, T., Tanaka, S., & Asada, T. (2013). Prevalence of depression an depressive symptoms among older Japanese people: comorbidity of mild cognitive impairment and depression. International Journal of Geriatric Psychiatry, 27 (3), 944-951.
  • Jensen, M.P., Karoly, P., & Braver, S. (1986). The measurement of clinical pain intensity: a comparison of six methods. Pain, 27 (1), 117-126.
  • Kaasalainen, S., & Crook, J. (2013). A comparison of pain-assessment tools for use with elderly long-term-care residents. The Canadian Journal of Nursing Research, 35 (4), 58-71.
  • Li, L., Liu, X., & Herr, K. (2007). Postoperative pain intensity assessment: a comparison of four scales in Chinese adults. Pain Medicine, 8 (8), 223-234.
  • Lukas, A., Niederecker, T., Gunther, I., Mayer, B., & Nikolaus, T. (2013). Self- and proxy report for the assessment of pain in patients with and without cognitive impairment: experiences gained in a geriatric settings. Zeitschrift fur Gerontologie und Geriatrie, 46 (3), 214-221.
  • Magni, E., Binetti, G., Bianchetti, A., Rozzini, R., & Trabucchi, M. (1996). Mini-Mental State Examination: normative study in italian elderly population. European Journal on Neurology, 3 (3), 198-202.
  • Mcauliffe, L., Nay, R., O'donnell, M., & Fetherstonhaugh, D. (2011). Pain assessment in older people with dementia: literature review. Journal of Advanced Nursing, 65 (1), 2-10.
  • Murray, T.M., Sachs, G.A., Stocking, C., & Shega, J.W. (2012). The symptom experience of community-dwelling persons with dementia: self and caregiver report and comparison with standardized symptom assessment measures. The American Journal of Geriatric Psychiatry, 20 (4), 298-305.
  • Neville, C., & Ostini, R. (2014) A psychometric evaluation of three pain rating scales for people with moderate to severe dementia. Pain Management Nursing, 15 (4), 798-806.
  • Nygaard, H.A., & Jarland, M. (2005) Are nursing home patients with dementia diagnosis at increased risk for inadequate pain treatment? International Journal Geriatric Psychiatry, 20 (8), 730-737.
  • Pautex, S., Herrmann, F., Le Lous, P., Fabjan, M., Michel, J.P., & Gold, G. (2005). Feasibility and reliability of four pain self-assessment scales and correlation with an observational rating scale in hospitalized elderly demented patients. The Journals of Gerontology, 60 (4), 524-529.
  • Price, D.D., McGrath, P.A., Rafii, A., & Buckingham, B. (1983). The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain, 17 (1), 45-56.
  • Reynolds, K.S., Hanson, L.C., DeVellis, R.F., Henderson, M., & Steinhauser, K.E. (2008). Disparities in pain management between cognitively intact and cognitively impaired nursing home residents. Journal of Pain and Symptom Management, 35 (4), 388-396.
  • Storti, M. (2009). La validazione di una scala di accertamento del dolore in pazienti con decadimento cognitive: la scala Abbey nella versione italiana. Recenti Progressi in Medicina, 100 (9), 405-409.
  • Storti, M., Braggion, M., Dal Santo, P., Fanchin, G., & Zanolin, M.E. (2012). Anziano istituzionalizzato e depressione: uno studio osservazionale multicentrico. Recenti Progressi in Medicina, 103 (4), 154-157.
  • Storti, M., Dal Santo, P., & Zanolin, M.E. (2008). Confronto fra due scale di valutazione del dolore in pazienti ospedalizzati affetti da grave demenza e non verbalizzanti. Professioni Infermieristiche, 61 (4), 210-215.
  • Storti, M., Zacchetti, R., Baraiolo, R., Crippa, A., Ferrari, A., Facheris, V., Ruggeri, L., Susta, R., & Menghi, V. (2011). Aderenza dei professionisti sanitari ai protocolli di rilevazione del dolore: l'indicatore Pain Measurement Aderence Index (PMAI). Scenario, 28 (1), 4-8.
  • Stuppy, D.J. (1998). The Faces Pain Scale: reliability and validity with mature adults. Applied Nursing Research, 11 (2), 84-89.
  • Takai, Y., Yamamoto-Mitani, N., Okamoto, Y., Koyama, K., & Honda, A. (2010). Literature review of pain prevalence among older residents of nursing homes. Pain Management Nursing, 11 (4), 209-223.
  • Tan, E.C., Jokanovic, N., Kopenen, M.P., Thomas, D., Hilmer, S.N., & Bell, J.S. (2015). Prevalence of analgesic use and pain in people with and without dementia or cognitive impairment in aged care facilities: a systematic review and meta-analysis. Current Clinical Pharmacology, 10 (3), 194-203.
  • Van Kooten, J., Binnekade, T.T., van der Wouden, J.C., Stek, M.L., Scherder, E.J., Husebo, B.S., Samlbrugge, M., & Hertogh, C.M. (2016). A review of pain prevalence in Alzheimer's, vascular, frontotemporal and Lewy Body dementias. Dementia and geriatric cognitive disorders, 41 (3-4), 220-232.
  • Ware, L.J., Epps, C,D., Herr, K., & Packard, A. (2006). Evaluation of the Faces Pain Scale, Verbal Descriptor Scale, Numeric Rating Scale, and Iowa Pain Thermometer in older minority adults. Pain Management Nursing, 7 (3), 117-125.
  • Weiner, D.K. (2007). Office management of chronic pain in the elderly. The American Journal of Medicine, 120 (4), 306-315.
  • Wheeler, M.S. (2006). Pain assessment and management in the patient with mild to moderate cognitive impairment. Home Healthcare Nurse, 24 (6), 354-359.
  • Wynne, C., Ling, S., & Remsburg, R. (2010). Comparison of pain assessment instruments in cognitively intact and cognitively impaired nursing home residents. Geriatric Nursing, 21 (1), 20-23.
  • Zanocchi, M., Maero, B., Nicola, E., Martinelli, E., Luppino, A., Gonella, M., Gariglio, F., Fissore, L., Bardelli, B., Obialero, R., & Molaschi, M. (2008). Chronic pain in a sample of nursing home residents: prevalence, characteristics, influence on quality of life (QoL). Archivies of Gerontology and Geriatrics, 47 (1), 121-128.
  • Zhou, Y., Petpichetchian, W., & Kitrungrote, L. (2011). Psychometric properties of pain intensity scales comparing among postoperative adult patients, elderly patients without and with mild cognitive impairment in China. International Journal of Nursing Studies, 48 (4), 449-457.