Assessment Of Post Operative Pain In Dementia Patients

2111 words - 9 pages

Assessment of Post-Operative Pain in Dementia Patients
A Review of the Literature
Janice Long
University of Massachusetts Boston

Author Note
This paper was prepared for NU362, Evaluating Research for Evidence-Based Nursing Practice, taught by Professor Lisa Sheldon for the current semester.
Assessment of Post-Operative Pain in Dementia Patients
A Review of the Literature
Introduction
The purpose of this paper is to present a discussion of the application and evaluation of Post-Operative pain management in elderly patients with dementia in a rehabilitation setting.
Conceptual-Theoretical-Empirical Structure (C-T-E)
Johnson’s Behavioral System Model is a model of nursing care that supports the development of efficient and effective behavioral functioning in the patient to prevent illness. The patient is recognized as a behavioral system composed of seven behavioral subsystems including affiliative, dependency, ingestive, eliminative, sexual, aggressive, and achievement. The purposeful requirements for these subsystems include protection from noxious influences, provision for a nurturing environment, and stimulation for growth. When any subsystem is imbalanced, it is the nurse’s role to help the patient return to a state of equilibrium.
The framework of this model is utilized throughout hospital settings to form a basis for all nursing decisions in respect to nursing diagnosis, care plans, discharge planning, and quality assurance (Reynolds & Cormack, 1991). This conceptual model focuses on the effects of internal and external environments that contribute to someone’s behavior. Pain (being the internal force) in patients with altered mental status usually manifests externally in non-verbal cues. Nursing as the external force can use tools that focus on the non-verbal cues given by the patients to accurately assess the pain and properly treat it.
Assessing and managing pain is an inevitable part of nursing and the care of patients. Incomplete relief of pain remains prevalent despite years of research due to barriers such as lack of knowledge and outlooks toward patients. Pain management involves pharmacological, non-pharmacological, and other approaches to prevent, reduce, or stop pain sensations and if managed well can facilitate recovery, prevent further health complications, and improve a patient’s quality of life (Pain Management, 2012). Patients with dementia most often present with altered mental status which can become hard to assess and treat pain successfully which can contribute to their internal and external behaviors causing them to become unstable. If potential pain is identified, a thorough assessment of the patient is vital and should be done on a regular basis before considering painkilling medications that could lead to more undesirable side effects. Distraction can be useful by changing the patient’s attention to stimuli other than the pain sensation making the pain more bearable though not completely...

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