Pain-Assessment-and-Management-疼痛评估和管理英文课件.ppt

* * * * * * * * * * * * * * * * * * * * Ask the patient = even persons with moderate impairment (e.g. MMSE=12) can still reliably report pain with good test-retest reliability. Preferred pain terminology is very important as the word for “pain” varies from person to person. Some people think of “pain” to be different from an intense ache or hurt. At bedside we should ask a variety of these qualifiers “Are you aching? Hurting? Having discomfort?” to illicit the best response. Use a pain scale that works for that particular individual and remain consistent throughout subsequent interviews with the same patient Use: -simplest, clear explanation, give examples -give time to grasp task and respond -repetition KEY It is important to use a pain scale whenever possible as it can help guide you in terms of treatment efficacy. Studies have shown that more than 80% of cognitively impaired persons are able to reliably complete a pain scale. The importance is in finding one that works for the individual. I will give you some examples in the next few slides. When describing the tool to a cognitively impaired individual you want to be patient and give simple and clear explanations, providing examples whenever possible. You need to give the patient time to process the information and formulate a response. You may have to repeat the instructions a few times before they get it. Keep in mind that these patients are often hard of hearing and have poor vision so you need to make sure they are wearing their glasses and hearing aids. High rate of completion of tools even with low MMSE (12) * Pain Intensity Scales Source: Acute Pain Management Guideline Panel. Acute Pain Management in Adults: Operative Procedures. Quick Reference Guide for Clinicians. Rockville, MD: US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research. February 1992. AHCPR Pub. No. 92-0019. In general, short simple verbal rating scales (e.g. no pain