BACKGROUND: Pain is very common among nursing home residents. The assessment of pain is a prerequisite for effective multiprofessional pain management. Within the framework of the German health services research project, ‘Action Alliance Pain-Free City Muenster’, the authors investigated pain assessment adherence according to the German national Expert Standard for Pain Management in Nursing, which is a general standard applicable to all chronic/acute pain-affected persons and highly recommended for practice.OBJECTIVES: To evaluate the state of pain assessment and to identify need for improvement in 12 nursing homes in a German city.METHODS: In the present study, the authors used an ex-post-facto design (survey methodology). Available written policies for routine pain assessment in residents ≥65 years of age were reviewed and a standardized online survey completed by 151 of 349 nurses in 12 nursing home facilities was conducted between September 2010 and April 2011.RESULTS: Most of the included nursing homes provided written policies for pain assessment, and the majority of nurses reported that they assess and regularly reassess pain. However, observational tools for residents with severe cognitive impairment and written reassessment schedules were lacking in many facilities or were inconsistent.CONCLUSIONS: Essentially, pain assessment appeared to be feasible in the majority of the German nursing homes studied. However, the absence or inconsistency of reassessment schedules indicate that pain management guidelines should include a detailed and explicit reassessment schedule for the heterogenic needs of nursing home residents. For residents with severe cognitive impairment, assessment tools are needed that are simple to use and clearly indicate the presence or absence of pain.

中文翻译：

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疼痛评估符合德国12个疗养院疼痛管理国家标准的要求

背景：疼痛在疗养院居民中非常普遍。疼痛评估是有效的多专业疼痛管理的先决条件。在德国卫生服务研究项目“行动联盟无痛城市明斯特行动”的框架内，作者根据德国国家护理疼痛管理专家标准对疼痛评估依从性进行了调查，该标准适用于所有慢性病/目的：评估疼痛评估的状态并确定德国城市12家疗养院的改善需求。方法：在本研究中，作者使用了事后评估。事实设计（调查方法）。在2010年9月至2011年4月之间，对适用于65岁以上≥65岁的居民进行常规疼痛评估的书面政策进行了审查，并由12家疗养院设施中的349名护士中的151名进行了标准化在线调查。结果：提供的大多数包括疗养院疼痛评估的书面政策，大多数护士报告他们评估并定期重新评估疼痛。但是，在许多机构中，缺乏针对患有严重认知障碍和书面重新评估时间表的居民的观察工具，或者该方法不一致。结论：从本质上讲，疼痛评估似乎在大多数研究的德国养老院中都是可行的。然而，重新评估计划表的缺乏或不一致表明，疼痛管理指南应包括针对养老院居民异质性需求的详细而明确的重新评估计划表。对于具有严重认知障碍的居民，需要使用易于使用并清楚表明疼痛存在或不存在的评估工具。