TIP OF THE WEEK
Consider psychological factors in pain perception
Psychological factors can influence pain perception and have profound implications for treatment. Consider the following factors in your efforts to manage pain.
LOCUS OF CONTROL
This refers to the perception of who is responsible for health outcomes: the individual, powerful others (i.e. nurse, doctor, or even STNA), or chance. Research suggests that as people age, they develop a more externalized locus of control and associate pain with the influence of others or chance. This might argue against psychological interventions in pain management in the elderly. However, locus of control orientation can become more internalized with the addition of psychologically based treatment.
Increased perceived control over pain may lead to decreased patient disability, decreased depression, and decreased pain intensity. Likewise, consider the possibility that psycho-educational interventions may lead to decreased external locus of control, improved sleep, improved pain tolerance, and decreased emotional disturbance in older adults.
ACTIVE COPING
This refers to the level of control that patients desire in their treatment. Despite a tendency to become more externally-oriented with age, older patients desire an active role in their own treatment and prefer to use physical and cognitive coping strategies that they can control.
A person who employs externally focused coping has an increased reliance on health care professionals and fewer positive coping strategies. A person who employs internally focused coping has an increased perception of control over pain as well as more active and adaptive coping strategies.
DEPRESSION
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Clinical depression is found in up to 80% of patients with chronic pain. Studies have shown a correlation between depression and perceived lack of control in pain patients as well as strong associations between pain, activity restriction, sleep disturbance, and depression.
As illustrated in the figure to the right, negative synergistic interactions have been identified between pain, depression, and insomnia.
Predictors of depression include pain, the number of medical conditions, and lack of social support. Furthermore, a lack of depression treatment leads to poor response to pain management.
RESOURCE SPOTLIGHT
Pain Management: What all residents and their families need to know *New!
This brochure includes facts about pain management that all nursing home residents and families need to know. Order 25 today for new admissions or for your lobby. Also available in the series: abuse/neglect, depression, nutrition/hydration, pressure sores, and urinary incontinence.
To order, click here and select “Nursing Home” in the drop-down box. Then, scroll to the bottom and add the Workforce Retention Resource CD-ROM to your cart. Finally, proceed to checkout. All resources in the Ohio KePRO Shopping Bag are free of charge to Ohio healthcare providers. Please allow 10 business days to process your request.
IN THE NEWS
HOSPITALS IMPROVE QUALITY OF CARE FOR THREE CONDITIONS, ACCORDING TO STUDY
March 21, 2007 -- Kaiser Network -- U.S. hospitals have made improvements in the care provided to heart attack, heart failure and pneumonia patients, according to a report released on Tuesday by the Joint Commission, AP/Long Island Newsday reports. The report, which examined whether more than 3,000 hospitals followed treatment guidelines for the three conditions, found that care consistently improved from 2002 to 2005. Read more >>
EXPANDING PASSPORT PROGRAM TO KEEP MORE AT HOME
March 15, 2007 -- Cincinnati Enquirer -- The proposal: Expanding Ohio's Passport program to allow another 5,600 seniors to participate. But as Gov. Ted Strickland calls for expanding a program aimed at doing just that, he should also look at increasing funding to the home health agencies that provide the service, said Cooper, chief financial officer for the Visiting Nurse Association of Greater Cincinnati. Read more >>
EXERCISE HELPS PREVENT FALLS IN ELDERLY
March 20, 2007 -- Spokesman Review -- Like a lot of people, former flight attendant Mary Nicholson wasn't an exerciser. But two years ago she changed all that – at age 71. For Nicholson, part of the motivation to exercise was to be strong and agile enough to avoid a fall. "I'm bound and determined I'm not going to fall and break a bone," she said during a workout that included balancing on one leg, working with weights and stair-climbing. Nicholson says she feels better, is stronger, and her balance is much improved. Read more >>
OHIO KEPRO EVENTS
COMMUNITY OF PRACTICE CONFERENCE CALLS
Choose one or more topics of interests and dial in to discuss best practices and barriers to improvement with your peers in the nursing home industry. These calls are designed for interactive discussion; come prepared to discuss your successes and barriers.
Dial-In: 1.800.895-1715
Conference ID: COP
Topic |
Call One |
Call Two |
Pressure Ulcers |
3/13/07, 10AM or 3/15/07, 2PM |
4/17/07, 10AM or 4/19/07, 2PM |
Pain |
3/27/07, 10AM or 3/29/07, 2PM |
4/24/07, 10AM or 4/26/07, 2PM |
Restraints |
4/3/07, 10AM or 4/5/07, 2PM |
5/1/07, 10AM or 5/3/07, 2PM |
For more information, please contact the Nursing Home Team at 1-800-385-5080
View all Ohio KePRO educational opportunities for nursing homes >>
INDUSTRY EVENTS
2007 DQA QUALITY FORUMS FOR NURSING HOMES
In April and May, the Ohio Division of Quality Assurance (DQA) is presenting one-half day quality forums to discuss current issues with Nursing Home Administrators, Directors of Nursing and Maintenance Supervisors (limited to two participants per facility, advanced registration is required). The quality forums will include the following topics: GPRA goals/restraint use guidelines, MRSA in LTC, LTC updates, enforcement updates, and life safety code updates.
Dementia: The Emerging Epidemic, A support group meeting for family, friends, and caregivers
May 10, 2007, 7:00pm to 8:30pm, Courtyard by Marriott, Springfield, OH.
Call OMH, Rita Brown at 937-525-3000 to register before May 3, 2007.
Navigating the MDS Through the Ohio Medicaid Reimbursement System
Ohio Department of Job and Family Services
June 11, 2007 or August 23, 2007
Call Cheryl Robertson at (614) 466-9088 for more information.
Upcoming CMS Webcasts
Advancing Excellence in Nursing Homes
April 23, 2007, 1:00 p.m.
From Institutional to Individual Care Part III: Clinical Case Studies in Culture Change
April 27, 2007, 1:00 p.m.
Medicare Learning Network: Learning resources and products for the healthcare professional.
Alzheimer’s Association Training Events
Case Western Reserve University School of Medicine Courses
Ohio Department of Health, Technical Assistance Program – New Programs
Ohio Health Care Association Events
An archive of The Nursing Home Weekly Update is available on our Web site. Click here >>
