Assessment and management of chronic pain in the older person living in the community.
OBJECTIVE
This paper reviews the nursing research literature on chronic pain in the older person living in the community and suggests areas for future research.


BACKGROUND
Chronic pain is a pervasive and complex problem that is difficult to treat appropriately. Nurses managing chronic pain in older people in domiciliary/home/community nursing settings face many challenges. To provide care, the many parameters of chronic pain which include the physical as well as the psycho-social impact and the effect of pain on patients and their families, must be carefully assessed. Beliefs of the older person about pain and pain management are also important.


METHODS
Relevant nursing studies were searched using CINAHL, Cochrane Database of Systematic Reviews, EMBASE and PUBMED databases using key words about pain and the older person that were appropriate to each database.


RESULTS
Tools to assess pain intensity in the older person have been studied but there has been less research on the other parameters of pain assessment or how the older person manages pain. An effective nurse-patient relationship is an important component of this process and one that needs more study. Few research studies have focused on how nurses can be assisted, or on the challenges, nurses' face, when managing this vulnerable population.


CONCLUSIONS
A broad approach at the organisational level will assist nurses to manage this health care issue.
Dewar
Anne
A
School of Nursing, Wesbrook Mall, Vancouver, Canada. dewar@nursing.ubc.ca
D000368:Aged; D001291:Attitude of Health Personnel; D002908:Chronic Disease; D003152:Community Health Nursing / Q000379:methods*; D005851:Geriatric Nursing / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006699:Home Care Services; D006801:Humans; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009730:Nursing Assessment / Q000379:methods; D010146:Pain / Q000175:diagnosis / Q000451:nursing*; D010147:Pain Measurement / Q000379:methods / Q000451:nursing; D011788:Quality of Life