Sjuksköterskors erfarenheter av att smärtbedöma personer med demenssjukdom och kognitiv svikt

Sammanfattning

Introduction: Dementia and cognitive impairment are common conditions among elderly patients. One of the symptoms is reduced communication ability. A patient with dementia or cognitive impairment cannot describe their pain in the same way as other patients. The nurse has a responsibility to assess the patient’s level of pain and provide good and safe care. Aim: The purpose was to explore nurses' experiences of identifying and treating pain in patients with dementia or cognitive impairment. Method: A literature review with a descriptive design and a qualitative approach. The search for articles was made in PubMed and the search produced 11 qualitative original articles. The articles were reviewed using the SBU review template and analysed thematically using Popenoe method of analysis. Results: Two main categories and four subcategories were identified. The main categories were: The complexity of pain identification in individuals with impaired cognitive function and Prerequisites and barriers to pain assessment. Nurses performing pain assessment on patients with dementia or cognitive impairment experienced uncertainty about the patient's pain intensity and their own ability to assess it. Structural problems such as unclear guidelines, uncertainty to which measurement tool to use and poor interprofessional communication were also among the experiences that nurses reported. Conclusion: Nurses who assess pain in patients with dementia or cognitive impairment often experience uncertainty regarding the patients’ responses and their own ability to evaluate pain. Unclear guidelines and insufficient education create challenges in their work. Increased education in the care of patients with dementia or cognitive impairment can enhance nurses’ competence and reduce unnecessary suffering among patients.