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Title: Exploring how healthcare professionals and family carers identify pain in people with dementia and limited verbal skills
Author: Swarbrick, Caroline Margaret
ISNI:       0000 0004 2682 4980
Awarding Body: University of Manchester
Current Institution: University of Manchester
Date of Award: 2009
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Aim: The aim of this research was to explore how nurses, physiotherapists, experienced dementia workers and informal carers (next of kin/family members) identify pain in people with dementia and limited verbal skills. This research comprises two studies, of which study two (quantitative) was informed by the findings of study one (qualitative). Study one: Study one was an exploratory study, which examined the issues involved in identifying pain in people with dementia. A total of six single-disciplined focus groups were undertaken comprising: nurses (hospital one n=4, hospital two n=6); physiotherapists (hospital one n=9, hospital two n=9); experience dementia workers from a postgraduate dementia care programme (n=3); and informal carers from the Alzheimer's Society (n=9). Using framework analysis, the focus group discussions were underpinned by two concepts: interpretations and changes in behaviour. Four themes emerged from the data comprising: knowledge and understanding; background of the person with dementia; pain identification; and roles and approaches. Integral to the theme of pain identification was behaviour, including facial expressions, body movements, vocalisations, actions and physiological indicators. These formed the basis of the questionnaire in study two. Study two: The aim of study two was to investigate how family carers (n=89) from the Alzheimer's Society identify pain in people with dementia, using a self-completed questionnaire. The most common behaviours considered indicative of pain in people with dementia (as reported by family carers) were 'grimace', 'rubbing', 'loud sounds', 'irritability' and 'change in skin colour'. Family carers reported that males with dementia displayed 'guarding' and 'aggression' as expressions of pain significantly more than females with dementia. In addition, younger people with dementia displayed 'use other limbs' and 'aggression' as indicators of pain significantly more than older people with dementia. Furthermore, younger family carers reported 'frown', 'close eyes', 'wince', 'grabbing', 'verbalisations', 'change in eating patterns', 'change in temper", 'crying' and 'change in skin colour' as indicators of pain in people with dementia significantly more than older family carers. Conclusion: The findings support the need for pain identification as a stagl' prior to and separate from that of pain assessment. 'Knowing the person' was considered important in identifying pain, highlighting 'the importance of family carer involvement'. 'Changes in behaviour' was central to identifying pain, using the behaviours reported by family carers in study two as guidance.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available