title: Nurses' perceptions of pain management for older-patients in the Emergency Department: A qualitative study.
abstract: 1) Identify themes arising from nurses' perceptions of assessing older-patients' pain; 2) use themes to guide development of optimal interventions to improve quality of pain assessment in the emergency department (ED).
  
  
  
  Nurse interviews (n=20) were conducted until theme saturation. They were transcribed, coded, and analyzed using qualitative methodology.
  
  
  
  Two major themes-nurse 'challenges' and 'strategies' to overcome challenges, and their subthemes - classified as 'patient-related' or 'system-related,' were salient in nurses' perceptions. Strategies nurses reported for managing challenges were based in their own professional lived experiences.
  
  
  
  A 2×2 framework was developed to conceptualize challenges, strategies, subthemes and their classifications, yielding 4 typologies comprising challenge types matched with appropriate strategy types. While emergent challenges and strategies are corroborated in the literature, the present study is the first to develop a scheme of typologies beneficial for guiding the development of optimal interventions to improve the quality of assessing pain in older-patients.
  
  
  
  The typology framework can guide the development of pain assessment tools and the needed combinations for assessing multidimensional pain in older-patients. Using the present findings, a new clinical intervention was shown to significantly improve pain management for older-patients in the ED.
authors: Section of Geriatrics and Palliative Medicine, Chicago, IL, USA. Electronic address: rbhat@medicine.bsd.uchicago.edu.
authors: Rita
authors: R
authors: Gorawara-Bhat
authors: Section of Geriatrics and Palliative Medicine, Chicago, IL, USA.
authors: Alexandra
authors: A
authors: Wong
authors: Section of Geriatrics and Palliative Medicine, Chicago, IL, USA.
authors: William
authors: W
authors: Dale
authors: Section of Geriatrics and Palliative Medicine, Chicago, IL, USA; Section of Emergency Medicine, Department of Medicine, The University of Chicago, Chicago, IL, USA.
authors: Teresita
authors: T
authors: Hogan
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D009741:Nursing Staff, Hospital / Q000523:psychology*; D059408:Pain Management / Q000379:methods* / Q000451:nursing*; D010147:Pain Measurement; D010465:Perception; D036301:Qualitative Research
keywords: Emergency department; Nurses professional experiences; Older patients; Pain assessment