An appreciative inquiry into older adults’ pain experience in long term care facilities: a pain education initiative

摘要

Background: The prevalence of pain in older adults living in long-term care homes is as high as 80% in developed countries. A Pain Initiative was implemented to improve the pain experience of older adults in two care homes in Vancouver, Canada. This initiative consisted of education and coaching to strengthen the staff teams’ competence and confidence in pain management, although it was not evaluated for effectiveness. Aim : A clinical research team explored the lived experiences of older adults and professional caregivers participating in the Pain Initiative. The two research questions were: what were the experiences of participating in the Pain Initiative of older adults, professional caregivers and nurse supervisors? and what are enabling factors for positive changes in older adults’ pain experiences? Methods : We used appreciative inquiry to identify enabling factors for effective pain management, staying consistent with the tradition of this method to focus on the strengths within an organisation. Older adults and nurse supervisors participated in one-to-one interviews, and professional caregivers participated in focus groups. Inductive thematic analysis was used to analyse the data. Findings : Enhanced awareness of older adults’ pain led to increased empathy in professional caregivers. Ongoing coaching, education and resources were enabling factors for effective pain management. The findings illustrate that person-centred practices for pain management in long-term care homes were enhanced through getting to know the older adult, teamwork, non-pharmacological solutions and effective clinical and team processes.