The implementation of a systematic work approach to pain issues in nursing homes indicates that an increased awareness, collaboration across and shared understanding among the team members of the pain assessment results can improve pain management and lead to decreased physical deterioration or the maintenance of physical and functional abilities among NH residents. Persisting positive attitudes seemed strengthened by continued assessment experiences and perceptions of improved pain management. In general, nurses from the outset were positive regarding pain assessments. Nursing pain related documentation was sparse. No significant changes in the use of drugs was found in any of the groups. Furthermore, 17/44 residents showed increased pain scores ≥ 30% over time, indicating pain/risk for pain 8 identified at the first assessment and 9 were new, i.e. In the intervention group, 13/44 residents showed decreased pain scores over the period, 14/44 had no pain score changes ≥ 30% in either direction measured with Doloplus-2. Comparison group ( n = 66 residents) Katz-ADL values showed increased dependency over time, while the intervention group demonstrated no significant change over time ( n = 98). Using both non-parametric statistics on residential level and generalized estimating equation (GEE) models to take clustering effects into account, the results revealed non-significant interaction effects for the primary outcome measures, while for ADL-dependency using Katz-ADL there was a significant interaction effect. Secondary outcome measures were ADL-dependency and pain documentation. Primary outcome measures were wellbeing and proxy-measured pain. Nurse group interviews were carried out twice. Resident data were collected baseline and at two follow-ups using validated scales and record reviews. No measures were taken in the comparison group pain management continued as before, but after the study corresponding training was provided. The intervention group after theoretical and practical training sessions, performed systematic pain assessments using predominately observational scales with external and internal facilitators supporting the implementation. Randomized nursing home assignment to intervention or comparison group. MethodsĪ cluster-randomized trial and a mixed-methods approach. The overall aim was to investigate effects of a pain management intervention on nursing homes residents and to describe staffs’ experiences of the intervention. Pain assessment is central to adequate pain management. Chronic pain affects nursing home residents’ daily life.
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