Sonja Kalinowski

Deficits in pain treatment in nursing homes in Germany: a cross-sectional study.

Current knowledge about the quality and appropriateness of pharmacological pain treatment in nursing home residents (NHR), particularly in NHR with moderate to severe cognitive impairment, is poor.

Interventions to address deficits of pharmacological pain management in nursing home residents – A cluster-randomized trial

To evaluate the effect of interventions for general practitioners and nursing home staff to improve pain severity and appropriateness of pain medication in nursing home residents (NHR).

Pain management intervention targeting nursing staff and general practitioners: Pain intensity, consequences and clinical relevance for nursing home residents

Although chronic pain is common in older adults, its treatment is frequently inappropriate. This problem is particularly prevalent in nursing home residents. We therefore developed an intervention to optimize pain management and evaluated its effects on pain intensity and pain interference with function in nursing home residents in Germany.

Falls Self-Efficacy in German Nursing Home Residents: Assessment of Validity and Determination of a Cutoff Point.

Approximately one in every two German nursing home residents falls at least once in a 1-year period and just as many report a fear of falling. It has been hypothesized that falls self-efficacy mediates the relationship between fear of falling and functional ability. The aim of the current study was to develop the German Nursing Home Falls Self-Efficacy Scale, examine its validity, and estimate a cutoff point to differentiate nursing home residents with low or high falls self-efficacy. Nursing home residents were assessed at baseline (n = 178, mean age = 83.7 years) and 6-month follow up (n = 115, mean age = 83.9 years). Factorial and construct validity analyses provided preliminary support for the validity of the scale. A cutoff point of 11.5 was generated by receiver operating characteristic curve analysis. This scale may assist health care professionals in differentiating between nursing home residents with low and high falls self-efficacy and supporting residents in providing appropriate interventions. [Res Gerontol Nurs. 2016; 9(3):134-144.].

Evaluation einer Fortbildung für Pflegende zum Schmerzmanagement in Pflegeheimen

ZusammenfassungHintergrundDie Schmerzversorgung von Pflegeheimbewohnerinnen ist nachweislich inadäquat.Ziel der ArbeitUm diesem Defizit zu begegnen, wurden im Projekt PAIN-Intervention eine Handlungsempfehlung zum angemessenen Schmerzmanagement entwickelt und auf dieser Basis Fortbildungen für Pflegende angeboten.Material und MethodenNach Durchführung der Ganztagsworkshops in der Interventionsgruppe bzw. der Basisinformation in der Kontrollgruppe zum Schmerzmanagement in Pflegeheimen schloss sich die anonyme, freiwillige Evaluation mit einem standardisierten Fragebogen an.ErgebnisseDer Ganztagsworkshop zur Optimierung des Schmerzmanagements wurde besser bewertet als die Basisinformation. Signifikante Unterschiede zugunsten der Interventionsgruppe zeigten sich bei der Bewertung der Austauschmöglichkeiten, der erlebten Sicherheit im Umgang mit den Schmerzen der Bewohnerinnen und bezüglich der Informationen über nichtmedikamentöse Maßnahmen. Trotz positiver Bewertung wird vielfach der Veränderungsbedarf im Schmerzmanagement als nichtnotwendig erachtet. Vorkenntnisse der Pflegenden zum Thema Schmerz führten in der Kontrollgruppe zu einer geringeren Erweiterung der Kenntnisse.SchlussfolgerungenUnterschiede in der Methodik und des Zeitrahmens sowie der damit verbundene Umfang der Inhalte nehmen Einfluss auf die Bewertung. Eine multiperspektivische und interaktive Herangehensweise ermöglicht auch bei heterogenen Gruppen bessere Evaluationsergebnisse.AbstractBackgroundThe treatment of pain in nursing home residents is known to be inadequate.ObjectiveIn order to address these deficiencies, pain management guidelines were developed as part of the PAIN-Intervention project. Based on these guidelines, continuing professional development measures for nurses were developed and evaluated.Material and methodsSpecifically, a full-day training workshop was implemented in an intervention group and a control group was provided with basic information on pain management in nursing homes. Participants subsequently evaluated the measures provided by completing an anonymous and voluntary questionnaire.ResultsThe full-day workshop on the optimization of pain management was evaluated better than the basic information. Significant differences in favor of the workshop were found in the areas of exchange of information, confidence in dealing with residents’ pain, and awareness of non-pharmaceutical measures. Despite this positive evaluation, many respondents did not perceive a substantial need for change in the management of pain. In the control group, participants with a higher prior knowledge showed less knowledge gain.ConclusionDifferences in methods, time frame, and scope of the contents covered influenced participants’ evaluations. A multiperspective and interactive approach leads to better evaluation outcomes, even in heterogeneous groups.

Pain, Fear of Falling, and Functional Performance Among Nursing Home Residents: A Longitudinal Study:

The aim of this study was to analyze the impact of being pain-affected and fear of falling on functional performance among nursing home residents, longitudinally. We used 6-month follow-up data from a cluster-randomized trial of 12 nursing homes (cluster level) with 239 nursing home residents at baseline (mean age, 95% confidence interval [CI] = 83.04 [81.40, 84.69], 70% women). The longitudinal analysis provided data on pain, fear of falling, functional mobility, and activities of daily living (individual level). The data revealed a trend indicating that pain-relieved nursing home residents showed better functional mobility over time. The results on fear of falling demonstrate obvious differences in the functional performance of nursing home residents cross-sectionally but not longitudinally. Nevertheless, the results underline the importance of an effective pain treatment to prevent decline in functional mobility among nursing home residents. Further longitudinal surveys are needed to verify the findings on functional performance.