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Nurses’ experiences of pain management for people with advanced dementia approaching the end of life: a qualitative study

de witt jensen, banin, Brazil, Kevin, passmore, peter, buchanan, hilary, maxwell, doreen, McIlfatrick, Sonja, morgan, Sharon, watson, Max and Parsons, Carole (2016) Nurses’ experiences of pain management for people with advanced dementia approaching the end of life: a qualitative study. Journal of Clinical Nursing, xx . pp. 1-10. [Journal article]

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DOI: 10.1111/jocn.13442

Abstract

Aims and objectives. To explore hospice, acute care and nursing home nurses’ experiences of pain management for people with advanced dementia in the final month of life. To identify the challenges, facilitators and practice areas requiring further support.Background. Pain management in end-stage dementia is a fundamental aspect of end of life care; however, it is unclear what challenges and facilitators nurses experience in practice, whether these differ across care settings, and whether training needs to be tailored to the context of care.Design. A qualitative study using semi-structured interviews and thematic analysis to examine data. Methods. 24 registered nurses caring for people dying with advanced dementia were recruited from ten nursing homes, three hospices, and two acute hospitals across a region of the United Kingdom. Interviews were conducted between June 2014 and September 2015.Results. Three core themes were identified: challenges administering analgesia, the nurse-physician relationship, and interactive learning and practice development. Patient-related challenges to pain management were universal across care settings; nurse- and organisation-related barriers differed between settings. A need for interactive learning and practice development, particularly in pharmacology, was identified.Conclusions. Achieving pain management in practice was highly challenging. A number of barriers were identified; however, the manner and extent to which these impacted on nurses differed across hospice, nursing home and acute care settings. Needs-based training to support and promote practice development in pain management in end-stage dementia is required.

Item Type:Journal article
Keywords:pain, palliative care, dementia, nurse, nurse education
Faculties and Schools:Faculty of Life and Health Sciences > School of Nursing
Faculty of Life and Health Sciences
Research Institutes and Groups:Institute of Nursing and Health Research
Institute of Nursing and Health Research > Managing Chronic Illness Research Centre
ID Code:34954
Deposited By: Professor Sonja McIlfatrick
Deposited On:27 Jul 2016 08:12
Last Modified:27 Jul 2016 08:12

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