Nurses’ Opinions of Pain and the Assessed Need for Pain Medication for the Elderly

The undertreatment of pain in the elderly living in nursing homes is a significant problem. In Swedish nursing homes, the registered nurse on duty is often responsible for 20-40 patients during the day with no daily contact from attending physicians. The aim of this study was to investigate the opinions of registered nurses regarding pain and the assessed need for pain medication for elderly patients using patient scenarios. Two patient scenarios were used in this study; a questionnaire and background information was provided. The scenarios consisted of one smiling patient and one grimacing patient, both with the same numeric rating scale value of pain, blood pressure, pulse rate, and respiration rate. Three questions regarding pain assessment and management followed the scenarios. The questionnaire was sent to all 128 registered nurses working daytime in elderly care in both municipal nursing homes and municipal home care in the mid-Sweden region. A total of 56 nurses participated, providing an answering frequency of 45%. Results showed that registered nurses with more experience did not have the same opinion about pain as the smiling patient and gave inadequate medication, which was not in accordance with recommendations from the county hospital and the World Health Organization.