Dokument: Medikamentöses Schmerzmanagement bei Menschen mit Demenz nach Hüft- oder Beckenfrakturen: eine systematische Übersichtsarbeit
| Titel: | Medikamentöses Schmerzmanagement bei Menschen mit Demenz nach Hüft- oder Beckenfrakturen: eine systematische Übersichtsarbeit | |||||||
| Weiterer Titel: | Drug-based pain management for people with dementia after hip or pelvic fractures: a systematic review | |||||||
| URL für Lesezeichen: | https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=51666 | |||||||
| URN (NBN): | urn:nbn:de:hbz:061-20191211-110251-9 | |||||||
| Kollektion: | Dissertationen | |||||||
| Sprache: | Deutsch | |||||||
| Dokumententyp: | Wissenschaftliche Abschlussarbeiten » Dissertation | |||||||
| Medientyp: | Text | |||||||
| Autor: | Moschinski, Kai [Autor] | |||||||
| Dateien: |
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| Beitragende: | Icks, Andrea [Gutachter] PD Dr. Thelen, Simon [Gutachter] | |||||||
| Stichwörter: | Pain, Analgesics, Drugs, Hip fractures, Pelvic fractures, Dementia, Alzheimer, Cognitive impairment, Cognitive disorders, Schmerzen, Schmerzmanagement, Hüftfrakturen, Beckenfrakturen, Alterstraumata, Demenz | |||||||
| Dewey Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften » 610 Medizin und Gesundheit | |||||||
| Beschreibungen: | Hintergrund: Studien zeigen, dass Menschen mit Demenz nach Hüft- oder Beckenfrakturen nicht die gleiche Menge an Schmerzmitteln erhalten wie Menschen, die kognitiv nicht beeinträchtigt sind. Bisher gibt es jedoch noch keine systematische Übersichtsarbeit darüber, die das Wissen zum medikamentösen Schmerzmanagement bei Menschen mit Demenz nach Hüft- oder Beckenfrakturen zusammenstellt und zusammenfassend analysiert.
Ziel: Identifikation und Analyse von Studien, die das medikamentöse Schmerzmanagement bei Menschen mit Demenz nach operativ oder konservativ versorgten Hüft- oder Beckenfrakturen in verschiedenen Settings untersuchen. Extraktion der Designs, Methoden und Variablen der Studien, sowie der verwendeten Instrumente zur Erfassung der Schmerzen, der verabreichten Medikamente und der kognitiven Fähigkeiten. Methode: Das Protokoll dieses systemischen Reviews wurde auf Basis der Anforderungskriterien des PRISMA-P Statements erstellt, das aus einer 27 Punkte umfassenden Checkliste und aus einem Vier-Phasen-Flussdiagramm besteht. Die Datenbanken MEDLINE, EMBASE, CINAHL, Web of Knowledge und ScienceDirect wurden durchsucht. Es wurden nur Studien eingeschlossen, die bis zum 31. Januar 2016 veröffentlicht worden waren. Die Datenextraktion, inhalts- und quantitativ beschreibende Analyse wurden systematisch ausgeführt. Außerdem wurde mittels zuvor ausgewählter Checklisten eine kritische Bewertung der wissenschaftlichen Qualität der eingeschlossenen Studien vorgenommen. Ergebnisse: Aus 7467 Treffern wurden 17 Studien eingeschlossen. Von diesen zeigten acht Studien, die auf Daten der Patienten basierten, die aus der klinischen Dokumentation entnommen worden waren, dass Menschen mit Demenz weniger Opioide als Schmerzmedikation erhielten als Menschen ohne kognitive Beeinträchtigung. Vier Studien, die sich auf Fragebögen bezogen, die von Pflegekräften ausgefüllt worden waren, kamen zu dem Ergebnis, dass kognitive Beeinträchtigung ein maßgebliches Hindernis für effektives Schmerzmanagement darstellt. Die zur Erfassung der kognitiven Fähigkeiten und der Schmerzen der Patienten eingesetzten Instrumente waren sehr heterogen. Die Erfassung der verabreichten Schmerzmittel erfolgte in allen Studien aktenbasiert. Schlussfolgerung: Nach Hüftfrakturen scheinen Menschen mit Demenz nicht die gleiche Menge an Schmerzmitteln zu erhalten wie Menschen ohne kognitive Beeinträchtigungen. Dies sollte in zukünftigen Studien berücksichtigt werden. Es gilt geeignete Instrumente anzuwenden, um sowohl kognitive Beeinträchtigungen als auch Schmerzen bei Menschen mit Demenz zu erfassen und das Schmerzmanagement entsprechend zu verbessern.Background: Studies show that people with dementia after hip or pelvic fracture do not receive the same amount of analgesia compared to those without cognitive impairment. So far, however, there is no systematic review that compiles and analyses the knowledge of drug-based pain-management in people with dementia after hip or pelvic fracture. Objective: Identification and analysis of studies investigating drug-based pain management in people with dementia after surgically or conservatively treated hip or pelvic fractures in various settings. Extraction of the designs, methods and variables of the studies, as well as the instruments used to measure the pain, the drugs administered and the mental status of the patients. Method/Design: The protocol for this systematic review was developed based on the requirements of the PRISMA-P statement, which consists of a 27-item checklist and a four-phase flowchart. The databases MEDLINE, EMBASE, CINAHL, Web of Knowledge and ScienceDirect were searched. Only studies that had been published up to the 31st of January 2016 were included. The data extraction, content and quantitative descriptive analysis were carried out systematically. In addition, a critical assessment of the scientific quality of the included studies was performed using previously selected checklists. Results: A total of 7467 studies were identified, out of which 17 studies were included. Of these, eight studies based on patient data taken from clinical documentation showed that people with dementia received fewer opioids for pain medication than people without cognitive impairment. Four studies based on professionals’ surveys also came to the conclusion that cognitive impairment is a major barrier to effective pain management. The instruments used to assess the mental status and the pain assessment of the patients were very heterogeneous. The assessment of the drugs administered in all of the studies based on patient data was achieved through chart reviews. Conclusion: After hip fractures, people with dementia do not seem to receive the same amount of analgesia as people without cognitive impairment. This should be considered in future research. It is important to use appropriate items to detect both cognitive impairment and pain in people with dementia and to improve pain management accordingly. | |||||||
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| Lizenz: |  Urheberrechtsschutz | |||||||
| Bezug: | Es wurden nur Studien eingeschlossen, die bis zum 31. Januar 2016 veröffentlicht worden waren. | |||||||
| Fachbereich / Einrichtung: | Medizinische Fakultät | |||||||
| Dokument erstellt am: | 11.12.2019 | |||||||
| Dateien geändert am: | 11.12.2019 | |||||||
| Promotionsantrag am: | 25.03.2019 | |||||||
| Datum der Promotion: | 26.11.2019 |
