摘要:

The successful treatment of chronic pain in older people requires meticulous diagnosis and a comprehensive assessment of pain, suffering, and disability. At a minimum, multidisciplinary assessment requires practitioners that are able to assess psychologic, medical, and physical factors that could affect the older person's ability to cope with pain. An integrated and tailored management program may include pharmacologic and other medical interventions, psychologic strategies, as well as physical and occupational therapies. In cases where conventional treatment efforts fail, multidisciplinary pain management clinics for older persons have been shown to be effective. Age should not be regarded as a barrier to effective pain management.

ISSN:0882-7524    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Pain in older adults is a complex multidimensional (biopsychosocial) problem that is always unpleasant and is frequently associated with physical disability, psychosocial distress, and reduced quality of life. Physical therapists knowledgeable about pain are in an excellent position to identify and manage problems related to pain and pain-related dysfunction for this older population. Unfortunately, although pain is prevalent, complex, and integral to health care, it has not been integral to health care education. Inadequate knowledge has led to inadequate assessment and management. Current evidence shows that optimum pain and disability management is predicated on a sound assessment. Optimal management of the person with pain involves education and activity guided by practitioners knowledgeable about the complexities of pain. Recommendations regarding pain and disability assessment and management by physical therapists are provided.

ISSN:0882-7524    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This article addresses the utilization of cognitive-behavioral therapy with older adults. An overview of the cognitive-behavioral perspective on pain and pain management and a brief review of the empirical support for this treatment approach are presented. A review is given of the relevant empirical treatment literature utilizing cognitive-behavioral therapy with samples of older adults, as is a review of the relevant developmental issues and suggestions for refinements to cognitive-behavioral therapy for older adults. Finally, suggestions for future research are made.

ISSN:0882-7524    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Occupational therapy can enable older individuals with chronic pain to increase participation in everyday activity. Intervention requires knowledge of issues related to assessment and treatment of chronic pain in older adults. Prescription of assistive devices is an important aspect of such therapy. A small exploratory study was conducted with 30 older individuals with chronic pain from lower extremity osteoarthritis to determine what assistive devices they had and how these devices were obtained. Most devices had been obtained without the assistance of a professional. Early occupational therapy intervention to prescribe assistive devices and to provide strategies to remain active despite pain may be beneficial.

ISSN:0882-7524    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The nursing role in multidisciplinary management of chronic pain in older adults is developing. Direction is provided through the results of two studies that assist in conceptualizing pain management methods and understanding the differences between older and younger adults in the use of methods. Findings suggest that more emphasis be placed on nonpharmacologic methods that promote active patient involvement. The nurse's role within a multidisciplinary approach requires knowledge of both pharmacologic and nonpharmacologic interventions and the application of this knowledge through such activities as assessment, teaching, monitoring patient self-management, and coordinating care among health care providers.

ISSN:0882-7524    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The critical need for well-developed pain management services within the long-term care sector of the health services industry has received little attention in the geriatric and pain literature. We discuss this need from the perspective of current health care trends, specifically, the standardization of clinical practice, the refocusing of outcome evaluation criteria, and the quality improvement movement. Observations relevant to the goal of improving pain management practices in long-term care are extrapolated from quality improvement studies on pain management and from the training and development and behavioral gerontology literature. We provide practical recommendations for using the available evidence to change pain management practices in long-term care.

ISSN:0882-7524    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Pain problems in old age are prevalent and often are complicated by life events. In this article, a 77-year-old woman whose chronic pain management and coping are significantly affected by multiple psychosocial stressors and various types of losses is discussed, with review of relevant literature. This case serves to illustrate issues of loss and grieving, caregiver burden, and family dynamics in relation to chronic pain management for older adults. Grief therapy and its role in pain management for older patients are discussed.

ISSN:0882-7524    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This study examines reliability (test-retest and interrater) and predictive validity of the Home Assessment Profile (HAP), a quantitative, performance-based home assessment instrument. As part of a prospective cohort study of falls risk in older adults, the homes of 159 community-dwelling male veterans with impaired mobility were assessed at baseline using the HAP. Participants were then followed for 6 months for falls. The intraclass correlation coefficient (ICC 1,3) was used to assess agreement both between raters and between days for the total HAP score. The ability of the HAP to predict falls was assessed using logistic regression, adjusting for age, cognition, and mobility level. Total HAP scores ranged from 4 to 64 for the interrater trials and from 9 to 57 for the test-retest trials. Agreement between raters was 0.92 and between days was 0.92 for total HAP scores. Adjusting for age, cognition, and mobility level, the HAP was a significant predictor of falls. The HAP is a reliable and valid quantitative instrument that may be a useful adjunct to comprehensive geriatric assessment.

ISSN:0882-7524    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0882-7524    

出版商:OVID    

年代:2001

数据来源: OVID