Non-pharmacological interventions to reduce pain in dementia: A quasi-experimental study

Abstract

This study evaluated a non-pharmacological intervention nursing protocol for pain control and assessment of its evolution in a cohort of patients with moderate-to-severe dementia residing in three long-term care facilities in a metropolitan area in Spain. The study was a quasi-experimental pre- and post-exploratory intervention. The presence of pain was evaluated before and after the interventions of nursing protocol for 7 days, carried out by nurses. 157 residents of three centers participated (mean age 81.8 years, 58.1% were women, 83.2% had severe or moderately severe dementia and 65.2%) had regularly scheduled analgesic treatment. At baseline evaluation, the prevalence of pain, assessed with the PAINAD scale was 43.9% and this increased to 73.5% when pain was measured during bathing. The implementation of the nursing protocol of non-pharmacological interventions produced a decrease in pain of 11% (p = 0.0001). Multivariate Ancova analysis demonstrated that non-pharmacological interventions were effective independently of other factors as pressure sores or gender. The implementation of non-pharmacological interventions in social health care centers can produce a decrease in pain for those with dementia.

Keywords: Cognitive impairment; Dementia; Non-pharmacological intervention; Nursing elderly; Pain.