Introduction
Pain is one of the common problems that affect many old people worldwide (Tse, Leung & Ho, 2012). Despite the high number of old people who are affected by it, this condition is normally undertreated. According to the Maslow Hierarchy Model of Needs, the high pain prevalence is likely to affect negatively the fulfillment of the psychological needs (Tse, Leung & Ho, 2012). This challenge comes in the wake of an increase in the life expectancy of senior citizens aged 65 years and above in the past few decades. Since 1999, the life expectancy of these group has improved by 11 percent (Tse, Leung & Ho, 2012). As of now, the average life expectancy of male senior citizens is 79.4 years while that of their female counterparts is 85.5 years (Tse, Leung & Ho, 2012). The Maslow model states that people tend to want to meet their physiological or basic needs before fulfilling other needs. At the bottom of the pyramid of this model, are basic needs, but at the top, there are other less important needs such as psychological and social ones.
When the context of the nursing home is looked at, it is clear that the provision of physical care can be compromised. The attainment of the Maslow needs can at times be challenging under these settings. The nursing home environment is associated with a decrease in social activities of the older people, reduced physical activity, feeling of loneliness, depression, and a mood of unhappiness (Tse, Leung & Ho, 2012). Those in nursing homes complain of the loss of privacy and control of their lives. These negative feelings could hamper the lives and health of the elderly living in nursing homes. Therefore, meeting the needs in the upper chamber of the Maslow model might be difficult.
On top of that, pain is another major problem that old people in nursing homes must deal with. Reports indicate that up to 80% of occupants of nursing homes record low to severe pain episodes in every three months (Tse, Leung & Ho, 2012). Pain is a common phenomenon that senior citizens have to deal with. Despite this realization, enough has not been done to help old people manage their pain.
What are the barriers that that limit the provision of pain management care to old persons living in nursing homes? In line with this, this paper seeks to identify the barriers that limit the provision of pain management care to old persons living in nursing homes. This endeavor has a lot of significance. It is important to identify the barriers that limit delivery of pain management to senior citizens. The identification of those barriers would help nurses in solving the pain problem among old people. In other words, nurses would understand what is needed to serve senior citizens with pain issues in nursing homes in a better way. It will offer insights to nursing policymakers on the management of pain among senior citizens living in nursing homes.
Literature Review
Different authors have studied the problem of pain management among old people. In one such study, Gelinas et al. (2012) sought to describe the perspectives of not only patients and their families, but also nurses on the usefulness, feasibility, and relevance non-pharmacological pain management solutions in the Intensive Care Unit. In that study, the authors recruited 32 nurses and six patients/family members where they were evaluated their experiences on non-pharmacological solutions of pain management in the ICU. From their findings, it was clear that non-pharmacological interventions offer an alternative way of managing pain among ICU patients (Gelinas et al., 2012). Even though the study was not narrowed down to older patients but patients in the ICU, it revealed that non-pharmacological interventions can help in the management of pain. This finding is helpful to the study at hand as it highlights a probable solution to the problem under study.
On the other hand, Phelan (2010) conducted a pilot study with the aim of assessing the likelihood of conducting a larger study, as well as the possibility of using pain education program in the enlightenment on pain management among old patients in acute settings. Through the use of promotional media and educational campaigns, the target population was more aware of their pain status. They were able to detect better and manage their pain. Again, this research is very vital to the project under study. It provides a sound recommendation that can be used to manage the challenge of pain in the target population. Through efficient use of promotional media and educational campaigns, old adults can detect pain in advance, as well as understand how to manage pain.
Another important study was conducted by Wadensten et al. (2010); this study evaluated why the efforts to manage pain are sluggish. The researchers assessed the extent of pain in a Swedish university hospital, and how pain is managed in that hospital. From their findings, the researchers noted that a significantly high number of patients encounter pain in the hospital setting. Also, pain detection tools are not adequately used, and this leads to poor pain detection and management. The findings of this study will help in addressing pain detection barriers.
Additionally, Chang et al. (2010) also researched on this topic although their objective was rather broad. The researchers sought to identify the needs of older people in ICUs. Chang et al. (2010) recognize the fact that there is an increasing number of older people that are being admitted in the ICUs. It is important to identify the perspectives of these senior citizens on their needs if their healthcare issues have to be addressed in a better manner. The identification of those practices will help nurses develop better approaches to managing the needs of the elderly in ICUs. Similarly, this article highlights some of the important aspects of managing elderly patients in the ICU. Those perspectives offer an umbrella of needs of senior citizens in ICUs, and this helps in the identification of best nursing practices that can be used to manage senior citizens in ICUs.
Lastly, Tse, Leung, and Ho (2012) note that pain is one of the common problems that affect many old people worldwide. These authors highlight that despite the high number of old people who are affected by it, this condition is normally undertreated. They bring into perspective the Maslow Hierarchy Model of Needs. Because of poor pain management protocols, the high pain prevalence is likely to affect negatively the fulfillment of the psychological needs (Tse, Leung & Ho, 2012). This challenge comes in the wake of an increase in the life expectancy of senior citizens aged 65 years and above in the past few decades. Since 1999, the life expectancy of these group has improved by 11 percent (Tse, Leung & Ho, 2012).
As of now, the average life expectancy of male senior citizens is 79.4 years while that of their female counterparts is 85.5 years (Tse, Leung & Ho, 2012). The Maslow model states that people tend to want to meet their physiological or basic needs before fulfilling other needs. At the bottom of the pyramid of this model, are basic needs, but at the top, there other less important needs such as psychological and social ones. The authors realize the fact that nursing home stay is not a walk in the park for the senior citizens because most of them do not like it. In their study, the researchers sought to identify the non-physiological and analgesics approaches that are used in the management of pain. Also, they explored the extent of pain among senior citizens in the nursing home. This research helps the topic under study by providing a detailed background information on pain management as it appertains to nursing homes and senior citizens hosted there.
Methodology
This research will employ a quantitative cross-sectional study. This design is observational in nature and is used whereby a subset of a given population is taken as a representative sample and the research conducted within a specified period. Like in this case, the research will be conducted in 6 months, and it will use a single nursing home as a representative sample of senior citizens in all nursing homes.
The study will be conducted in a nursing home. A nursing home has been chosen because it hosts senior citizens with different needs, and pain is one of the issues that this population faces. Also, having access to this population is easier because they are located in one place rather than walking from house to house to interview potential participants. Sampling will be randomly in the institution. Both males and females will be taken into consideration. The requirements for participation would include the following:
Each participant must be a resident in the nursing home;
Should volunteer to take part in the study because no incentives will be given out;
Should be in stable condition to talk; be interviewed;
This paper will utilize utilized the following tools in the data collection process.
Geriatric Pain Assessment Tool (GPA);
Geriatric Depression Assessment tool (GDA);
Revised UCLA Loneliness Scale (RELS) and;
Subjective Happiness Scale (SHS).
Firstly, there will be descriptive statistical analysis of any quantitative using SPSS Version 15;
Man-Whitney U tests as a way of assessing differences in pain and non-pain groups and;
Spearman’s Rho Correlations as a way of assessing the association between psychological and pain parameters.
In summary, this quantitative cross-sectional study seeks to identify the barriers that limit the provision of pain management care to old persons living in nursing homes. The research will recruit a sample of 30 senior citizens from a nursing home on a voluntary basis whereby their responses will be collected, coded and analyzed using SPSS software.
In conclusion, this paper emphasizes the important of identifying the barriers that limit delivery of pain management to senior citizens. The identification of those barriers would help nurses in solving the pain problem among old people. In other words, nurses will understand what is needed to serve senior citizens with pain issues in nursing homes in a better way. It will offer insights to nursing policymakers on the management of pain among senior citizens living in nursing homes.
Discussion Board
Pain is one of the common problems that affect many old people worldwide (Tse, Leung & Ho, 2012). Despite the high number of old people who are affected by it, this condition is normally undertreated. Pain is a common phenomenon that senior citizens have to deal with. Despite this realization, enough has not been done to help old people manage their pain. What are the barriers that that limit the provision of pain management care to old persons living in nursing homes? In line with this, this paper seeks to identify the barriers that limit the provision of pain management care to old persons living in nursing homes.
Possible Sampling Methods
Random sampling
Random sample selection helps eliminate research-based bias. To use this method, participants will be selected randomly as per their room number.
Cluster sampling
Similarly, cluster sampling can be used when there is evidence of natural heterogeneity like in the case of the sample under study. In this case, race and gender are factors that contribute to such heterogeneity.
Inclusion Strategy
Each participant must be a resident in the nursing home;
Should volunteer to take part in the study because no incentives will be given out;
Should be in stable condition to talk; be interviewed;
Recruitment strategy
A nurse will be used to inform the participants about the research process as he/she attends to them. Those that will agree to take part in the study will be required to inform the nurse. The hospital's review board will be informed about the research, and it will be expected to give their consent before the nurses inform the potential participants. It will help guarantee the confidentiality and privacy of the participants, as well as ensure ethical consideration is taken into account.
References
Chang, W. et al. (2010). Care Needs of Older Patients in the Intensive Care Units. Journal of Clinical Learning, 21, pp.825-32.
Gelinas, C. et al. (2012). Patients and ICU Nurses’ Perspectives of Non-Pharmacological Interventions for pain Management. British Association of Critical Care Nurses, 18(6), 307-18.
Phelan, C. (2010). An innovative approach to targeting pain in older people in the acute care setting. Contemporary Nurse 35(2): 221–233.
Tse, M., Leung, J., and Ho, S. (2011).Pain and psychological well-being of older persons living in nursing homes: an exploratory study in planning patient-centred intervention. Journal of Advanced Nursing, pp. 312-21.
Wadensten, B. et al. (2011). Why IS Pain not being Assessed Adequately? Results of a Pain Prevalence Study in a University Hospital in Sweden. Journal of Advanced Nursing, 20, 624-35.
Appendix
Questionnaire
Demographic Information
Age..
Gender.
Race
Pain Detection and management
Have you encountered pain in the last three months?
If yes, which part was paining you?
How do you manage your pain?
Does the hospital help you in pain management? If yes, how? .
How can you rate the pain management care provided by nurses?
Very Poor [ ] Poor [ ] Fair [ ] Good [ ] Very Good [ ] Excellent [ ]
Are there factors to that limit you in detecting such pain?
If yes, name them
Are there factors that limit how pain management care is given to you?
Are there areas you would want to see improvement?
