A tool doesn’t add anything”. The importance of added value: use of observational pain tools with patients with advanced dementia approaching the end of life - a qualitative study of physician and nurse experiences and perspectives

Bannin De Witt Jansen, Kevin Brazil, Peter Passmore, Hilary buchanan, doreen maxwell, Sonja J McIlfatrick, Sharon morgan, Max Watson, Carole Parsons

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Observational Pain Tools (OPTs) are widely recommended in healthcare policies, clinical guidelines and recommendations for pain assessment and management. However, it is unclear whether and how these tools are used for patients with advanced dementia approaching the end of life. Aim: To explore hospice, secondary and primary care physicians’ and nurses’ use of OPTs with patients dying with advanced dementia and their perspectives on practice development and training needs. Methods: Twenty-three physicians and 24 nurses with experience of caring for people dying with advanced dementia were recruited from primary care surgeries (n=5), hospitals (n=6), hospices (n=4) and nursing homes (n=10). Semi-structured, face-to-face interviews were conducted. Interviews were digitally recorded, transcribed verbatim and thematic analysis applied to identify core themes. Results: Three key themes emerged: (1) use of OPTs in this vulnerable patient population; (2) barriers to the use of OPTs and lack of perceived ‘added value’ and (3) perspectives on practice development and training in pain assessment in advanced dementia at end of life. Just over one-quarter of participants (n=13) routinely used OPTs. Reasons for non-use included perceived limitations of such tools, difficulties with their use and integration with existing practice and lack of perceived ‘added value’. Most participants strongly emphasised a need for ongoing training and development which facilitated transfer of knowledge and multidisciplinary skills across professions and specialties. Conclusions: Health professionals require ongoing support in developing and integrating change to existing pain assessment protocols and approaches. These findings have important implications for health education, practice and policy
LanguageEnglish
Pages1346-1354
JournalInternational Journal of Geriatric Psychiatry
Volume33
Issue number10
Early online date1 Jul 2018
DOIs
Publication statusE-pub ahead of print - 1 Jul 2018

Fingerprint

Dementia
Nurses
Physicians
Pain
Pain Measurement
Interviews
Hospice Care
Secondary Care
Hospices
Primary Care Physicians
Vulnerable Populations
Pain Management
Health Policy
Nursing Homes
Health Education
Primary Health Care
Guidelines
Delivery of Health Care
Health

Keywords

  • dementia
  • education
  • medical
  • nurses
  • nursing
  • pain
  • pain assessment
  • pain measurement;
  • palliative care
  • physicians

Cite this

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title = "A tool doesn’t add anything”. The importance of added value: use of observational pain tools with patients with advanced dementia approaching the end of life - a qualitative study of physician and nurse experiences and perspectives",
abstract = "Background: Observational Pain Tools (OPTs) are widely recommended in healthcare policies, clinical guidelines and recommendations for pain assessment and management. However, it is unclear whether and how these tools are used for patients with advanced dementia approaching the end of life. Aim: To explore hospice, secondary and primary care physicians’ and nurses’ use of OPTs with patients dying with advanced dementia and their perspectives on practice development and training needs. Methods: Twenty-three physicians and 24 nurses with experience of caring for people dying with advanced dementia were recruited from primary care surgeries (n=5), hospitals (n=6), hospices (n=4) and nursing homes (n=10). Semi-structured, face-to-face interviews were conducted. Interviews were digitally recorded, transcribed verbatim and thematic analysis applied to identify core themes. Results: Three key themes emerged: (1) use of OPTs in this vulnerable patient population; (2) barriers to the use of OPTs and lack of perceived ‘added value’ and (3) perspectives on practice development and training in pain assessment in advanced dementia at end of life. Just over one-quarter of participants (n=13) routinely used OPTs. Reasons for non-use included perceived limitations of such tools, difficulties with their use and integration with existing practice and lack of perceived ‘added value’. Most participants strongly emphasised a need for ongoing training and development which facilitated transfer of knowledge and multidisciplinary skills across professions and specialties. Conclusions: Health professionals require ongoing support in developing and integrating change to existing pain assessment protocols and approaches. These findings have important implications for health education, practice and policy",
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A tool doesn’t add anything”. The importance of added value: use of observational pain tools with patients with advanced dementia approaching the end of life - a qualitative study of physician and nurse experiences and perspectives. / De Witt Jansen, Bannin; Brazil, Kevin; Passmore, Peter; buchanan, Hilary; maxwell, doreen; McIlfatrick, Sonja J; morgan, Sharon; Watson, Max; Parsons, Carole.

In: International Journal of Geriatric Psychiatry, Vol. 33, No. 10, 01.07.2018, p. 1346-1354.

Research output: Contribution to journalArticle

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T1 - A tool doesn’t add anything”. The importance of added value: use of observational pain tools with patients with advanced dementia approaching the end of life - a qualitative study of physician and nurse experiences and perspectives

AU - De Witt Jansen, Bannin

AU - Brazil, Kevin

AU - Passmore, Peter

AU - buchanan, Hilary

AU - maxwell, doreen

AU - McIlfatrick, Sonja J

AU - morgan, Sharon

AU - Watson, Max

AU - Parsons, Carole

PY - 2018/7/1

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N2 - Background: Observational Pain Tools (OPTs) are widely recommended in healthcare policies, clinical guidelines and recommendations for pain assessment and management. However, it is unclear whether and how these tools are used for patients with advanced dementia approaching the end of life. Aim: To explore hospice, secondary and primary care physicians’ and nurses’ use of OPTs with patients dying with advanced dementia and their perspectives on practice development and training needs. Methods: Twenty-three physicians and 24 nurses with experience of caring for people dying with advanced dementia were recruited from primary care surgeries (n=5), hospitals (n=6), hospices (n=4) and nursing homes (n=10). Semi-structured, face-to-face interviews were conducted. Interviews were digitally recorded, transcribed verbatim and thematic analysis applied to identify core themes. Results: Three key themes emerged: (1) use of OPTs in this vulnerable patient population; (2) barriers to the use of OPTs and lack of perceived ‘added value’ and (3) perspectives on practice development and training in pain assessment in advanced dementia at end of life. Just over one-quarter of participants (n=13) routinely used OPTs. Reasons for non-use included perceived limitations of such tools, difficulties with their use and integration with existing practice and lack of perceived ‘added value’. Most participants strongly emphasised a need for ongoing training and development which facilitated transfer of knowledge and multidisciplinary skills across professions and specialties. Conclusions: Health professionals require ongoing support in developing and integrating change to existing pain assessment protocols and approaches. These findings have important implications for health education, practice and policy

AB - Background: Observational Pain Tools (OPTs) are widely recommended in healthcare policies, clinical guidelines and recommendations for pain assessment and management. However, it is unclear whether and how these tools are used for patients with advanced dementia approaching the end of life. Aim: To explore hospice, secondary and primary care physicians’ and nurses’ use of OPTs with patients dying with advanced dementia and their perspectives on practice development and training needs. Methods: Twenty-three physicians and 24 nurses with experience of caring for people dying with advanced dementia were recruited from primary care surgeries (n=5), hospitals (n=6), hospices (n=4) and nursing homes (n=10). Semi-structured, face-to-face interviews were conducted. Interviews were digitally recorded, transcribed verbatim and thematic analysis applied to identify core themes. Results: Three key themes emerged: (1) use of OPTs in this vulnerable patient population; (2) barriers to the use of OPTs and lack of perceived ‘added value’ and (3) perspectives on practice development and training in pain assessment in advanced dementia at end of life. Just over one-quarter of participants (n=13) routinely used OPTs. Reasons for non-use included perceived limitations of such tools, difficulties with their use and integration with existing practice and lack of perceived ‘added value’. Most participants strongly emphasised a need for ongoing training and development which facilitated transfer of knowledge and multidisciplinary skills across professions and specialties. Conclusions: Health professionals require ongoing support in developing and integrating change to existing pain assessment protocols and approaches. These findings have important implications for health education, practice and policy

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KW - education

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KW - pain assessment

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KW - palliative care

KW - physicians

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