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The pain cues of cognitively impaired elderly people: an ethnoscientific study of gerontological nurses’ perspectives

University of British Columbia

Many gaps exist in our ability to detect and assess pain in cognitively impaired elderly people. In this study, an ethnoscientific approach was used to access gerontological nurses' knowledge of pain in the cognitively impaired elderly. In keeping with an ethnoscientific approach, judgement sampling, a nonprobability method for selection of knowledgable informants was used to select six gerontological nurse participants. All informants were over the age of thirty and had between six and fifteen years of experience working with cognitively impaired elderly people. Two data collection procedures were used; story telling interviews and retrospective chart reviews. The story telling interviews involved a systematic exploration of gerontological nurses' observations and perceptions caring for cognitively impaired elderly people in pain. Formal elicitation procedures were used as the framework for the interviews. As such, both the questions and the answers were discovered by the nurse informants. The second data source, retrospective chart reviews, focused on the written language other nurses used to describe pain. The chart review was intended to give breadth to the data that was collected in the interviews. Twenty-one charts of cognitively impaired elderly people were reviewed, sixteen were included in the study and five were excluded. A process of constant comparative analysis was used to determine the meanings nurses attached to the words and phrases they used to describe their observations. The findings from this study revealed that nurses use three pain cue groupings, overt behaviour, appearance and sounds. In addition, the findings revealed that the gerontological nurses in this study were able to integrate "knowing the patient" with knowing by intuitive perception. Together, each method of knowing enhanced the nurses ability to infer that pain was a problem for an impaired elder.

Thesis/Dissertation

application/pdf

2009-01-14

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http://hdl.handle.net/2429/3655

Nursing

University of British Columbia

UBCV

DSpace