International journal of palliative nursing
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Pain is prevalent among older people, yet is often under-recognised and undertreated in people with dementia. The nurse has a central role in identifying and appropriately assessing pain in order to provide effective treatment. Research however suggests there are significant deficits in this area. ⋯ Nurses play a key role in the effective management of pain through the use of pain assessment tools, behavioural observation, and analgesic choice. Pain assessment in dementia remains challenging for nurses due to the complexity and individualisation of pain behaviours. The accessibility of appropriate training, workforce stability and a standardised approach to pain assessment are key to the successful management of pain in older people with dementia.
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Comparative Study
The effect of a care bundle on nursing staff when caring for the dying.
Most Australians die in acute hospital settings. Despite this, hospitals remain ill-equipped to care for dying patients with hospital deaths not uncommonly perceived as distressing by both patients and their families. As a quality improvement project, a care bundle for the dying was developed and piloted on two medical wards. The aim of this study was to examine whether or not the quality initiative had any effect on the ward nurse's attitudes and self-assessed competency to care for dying patients. ⋯ Further research is required to understand if such an initiative approach may, in the long term, positively impacts attitude. This is highly relevant given the increasing numbers of people likely to die in acute care.
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Neuropathic pain in people with cancer (part 2): pharmacological and non-pharmacological management.
The aim of this paper is to provide an overview of the management of neuropathic pain associated with cancer and to provide helpful clinical advice for nurses working with patients who may have neuropathic pain. While cancer pain is a mixed-mechanism pain, this article will focus only on neuropathic pain management. The impact of neuropathic pain on patients' quality of life is great and while many patients recover from their cancer, a significant number continue to suffer from a neuropathic pain syndrome. ⋯ Specific drugs for neuropathic pain may be effective for some patients, but not all; therefore, ongoing and comprehensive assessment and management are required. Furthermore, these patients may require trials of several drugs before they find one that works for them. It is important for nurses to understand neuropathic pain, its manifestation, impact on quality of life and management when nursing patients with neuropathic pain associated with cancer.