Table IV.
Frequency characteristics of obstacles to optimal pain assessment and treatment in elderly patients associated with nursing staff, in hospitals with and without the certificate
| Barrier | Hospital | Mean | Standard deviation | P-value | |
|---|---|---|---|---|---|
| 1 | Not knowing older patients’ pain levels due to inadequate time spent with them | C N/C |
3.90 3.87 |
1.41 1.40 |
Z = –0.781; p = 0.435 |
| 2 | Not knowing how much pain is acceptable to each older patient (e.g., pain tolerance, discomfort level) | C N/C |
3.89 3.80 |
1.35 1.32 |
Z = –1.673; p = 0.094 |
| 3 | Not knowing whether to believe the older patient's pain report or the family's perception of the person's pain instead | C N/C |
3.84 3.78 |
1.31 1.33 |
Z = –1.181; p = 0.238 |
| 4 | Difficulty contacting or communicating with physicians to discuss treatment of pain in older patients | C N/C |
3.82 3.83 |
1.56 1.59 |
Z = –0.188; p = 0.853 |
| 5 | Difficulty contacting or communicating with physicians to discuss pain assessment findings in older patients | C N/C |
3.77 3.81 |
1.59 1.62 |
Z = –0.427; p = 0.670 |
| 6 | Lack of clinical confidence in assessing a variety of types of pain in older patients | C N/C |
3.70 3.69 |
1.44 1.42 |
Z = –0.177; p = 0.860 |
| 7 | Difficulty believing pain reports by older patients because they are inconsistent from one time to the next, and do not match their non-verbal behavior | C N/C |
3.60 3.60 |
1.23 1.24 |
Z = –0.214; p = 0.831 |
| 8 | Concentrating on administering regularly scheduled medications and not checking for and offering p.r.n. pain relief unless the patient requests it | C N/C |
3.53 3.43 |
1.30 1.40 |
Z = –1.803; p = 0.071 |
| 9 | The tendency to document only if pain relief is not achieved or if the patient refuses pain medication | C N/C |
3.43 3.40 |
1.58 1.52 |
Z = –0.488; p = 0.626 |
| 10 | Not expecting pain in older patients on our unit unless the diagnosis provides a clue to pain as a potential symptom | C N/C |
3.24 3.21 |
1.27 1.35 |
Z = –0.812; p = 0.417 |
| 11 | Uncertainty about how to best time the administration of p.r.n. pain medications when ordered along with scheduled pain medications in older patients | C N/C |
3.15 3.09 |
1.22 1.28 |
Z = –1.255; p = 0.209 |
| 12 | Not having a consistent way of receiving tips from nurses on previous shifts about pain assessment and management strategies for each of my older patients | C N/C |
3.14 3.15 |
1.41 1.39 |
Z = –0.119; p = 0.905 |
| 13 | Inconsistent practices around giving p.r.n. medications for an older patient (because the decision to administer pain medication is up to the assigned nurse, and varies from one to another) | C N/C |
2.97 2.93 |
1.43 1.42 |
Z = –0.677; p = 0.498 |
| 14 | My own reluctance to give pain medication to older patients for fear of overmedicating | C N/C |
2.54 2.57 |
1.38 1.37 |
Z = –0.330; p = 0.741 |
Hospital: C – hospital with certification, N/C – hospital without certification. P – is for the test of difference between hospital with certification and hospital without certification.