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Barriers and Facilitators in Pain Management in Long-Term Care Institutions: A Qualitative Study*

Published online by Cambridge University Press:  31 March 2010

Patricia Fox ,
Patricia Solomon ,
Parminder Raina  and
Alejandro Jadad
Patricia Fox*
Affiliation:
School of Rehabilitation Science, McMaster University Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto
Patricia Solomon
Affiliation:
School of Rehabilitation Science, McMaster University
Parminder Raina
Affiliation:
Evidence-Based Practice Centre, McMaster University Department of Clinical Epidemiology and Biostatistics, McMaster University
Alejandro Jadad
Affiliation:
Departments of Health Policy, Management and Evaluation, and Anaesthesia, University of Toronto Centre for Global eHealth Innovation, University Health Network and University of Toronto
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : Patricia Fox, Physiotherapy Research Coordinator, Mobility Program Clinical Research Unit, Suite 315, 70 Richmond, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8. (foxp@smh.toronto.on.ca)
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Abstract

The purpose of this study was to identify barriers to the management of pain in long-term care institutions. Formal caregivers practising in four long-term care institutions in Hamilton, Ontario participated in eight focus groups. Participants included 6 physicians, 19 registered nurses, 8 registered practical nurses, 13 health care aides and 8 occupational therapists or physiotherapists. Three types of barriers were found: caregiver-related, patient-related and systems-related. Four themes for facilitating pain management were identified: (a) caregivers knowing the patient, (b) family support, (c) caregivers demonstrating understanding and compassion, and (d) teamwork by caregivers. Formal caregivers practising in long-term care institutions encounter a multitude of barriers that hinder the adequate assessment and treatment of pain, such as caregiver beliefs and knowledge and cognitive impairment in patients. Innovative strategies and strong political will are needed to overcome them.

Keywords

agingolder adultspain managementlong-term care institutionsqualitative studyfocus groupsformal caregiversvieillissementgestion de la douleurpersonnes agéeséstablissements de soins de longue duréeétude qualitativegroupes témoinsprofessionnels de la santé
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 23 , Issue 3 , Fall/Automne 2004 , pp. 267 - 278
Copyright
Copyright © Canadian Association on Gerontology 2004

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Footnotes

*

Patricia Fox was an R. Samuel McLaughlin Foundation research fellow at St. Peter's Hospital in Hamilton, Ontario. Dr. Jadad was supported by a National Health Research Scholars Award from Health Canada. This study was supported by a grant from St. Peter's Hospital Foundation. We gratefully acknowledge the assistance of the caregivers of St. Peter's Hospital, Macassa Lodge, Wentworth Lodge, and Shalom Village who participated in the study. We also thank St. Peter's Hospital, Macassa Lodge, Wentworth Lodge, and Shalom Village for their support.

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