ArticleBMC medical informatics and decision making2015
The relative meaning of absolute numbers: the case of pain intensity scores as decision support systems for pain management of patients with dementia.
Article in BMC medical informatics and decision making, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 27 citations in OpenAlex.
- Pain Management in Cognitively Impaired Older Adults.International journal of nursing and health care research · 2024Article
- Pain management for people with dementia: a cross-setting systematic review and meta-ethnography.British journal of pain · 2023Article
- Exploring ways to enhance pain management for older people with dementia in acute care settings using a Participatory Action Research approach.International journal of older people nursing · 2022Article
- "A catalyst for action": Factors for implementing clinical risk prediction models of infection in home care settings.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- The Influence of Chronic Pain on Number Sense and Numeric Rating Scale: A prospective Cohort Study.Anesthesiology and pain medicine · 2020Article
- The challenge of pain identification, assessment, and management in people with dementia: a qualitative study.BJGP open · 2020Article
- The Influence of Chronic Pain and Cognitive Function on Spatial-Numerical Processing.Frontiers in behavioral neuroscience · 2018Article
- A Technical Note on the PainChek™ System: A Web Portal and Mobile Medical Device for Assessing Pain in People With Dementia.Frontiers in aging neuroscience · 2018Article
- Clinimetric properties of the electronic Pain Assessment Tool (ePAT) for aged-care residents with moderate to severe dementia.Journal of pain research · 2018Article
- Intrathecal pain management: a team-based approach.Journal of pain research · 2017Review
- The assessment and management of pain in patients with dementia in hospital settings: a multi-case exploratory study from a decision making perspective.BMC health services research · 2016Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundAssessment and management of pain in patients with dementia is known to be challenging, due to patients' cognitive and/or communication difficulties. In the UK, pain in hospital is managed through regular assessments, with the use of pain intensity scores as triggers for action. The aim of this study was to understand current pain assessment practices, in order to later inform the development of a decision support tool designed to improve the management of pain for people with dementia in hospital.
methodsAn exploratory study was conducted in four hospitals in the UK (11 wards), with observations of patients with dementia (n = 31), interviews of staff (n = 52) and patients' family members (n = 4) and documentary analysis. A thematic analysis was carried out, structured along dimensions of decision making. This paper focuses on the emergent themes related to the use of assessment tools and pain intensity scores.
resultsA variety of tools were used to record pain intensity, usually with numerical scales. None of the tools in actual use had been specifically designed for patients with cognitive impairment. With patients with more severe dementia, the patient's body language and other cues were studied to infer pain intensity and then a score entered on behalf of the patient. Information regarding the temporality of pain and changes in pain experience (rather than a score at a single point in time) seemed to be most useful to the assessment of pain.
conclusionsGiven the inherent uncertainty of the meaning of pain scores for patients with dementia, numerical scales were used with caution. Numerical scores triggered action but their meaning was relative - to the patient, to the clinician, to the time of recording and to the purpose of documenting. There are implications for use of data and computerized decision support systems design. Decision support interventions should include personalized alerting cut-off scores for individual patients, display pain scores over time and integrate professional narratives, mitigating uncertainties around single pain scores for patients with dementia.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.