Skip to main content
Log in

Probleme bei der Erkennung von Schmerzen in der Geriatrie

Problems recognizing pain in geriatrics

  • Originalien
  • Published:
Der Schmerz Aims and scope Submit manuscript

Zusammenfassung

Fragestellung:

Ziele dieser Untersuchung waren, in einer geriatrischen Einrichtung Patienten mit schwierig zu erkennendem Schmerzproblem zu quantifizieren und zu charakterisieren.

Methode:

124 geriatrische Patienten und ihre behandelnden Ärzte wurden in einer Querschnittuntersuchung zu Schmerzen befragt. Ärzte und Patienten schätzten die Schmerzintensität und den Einfluss der Schmerzen auf den Alltag mit einer verbalen Skala ein. Die Aussagen der Patienten und der behandelnden Ärzte bildeten die Grundlage für die Bildung von Gruppen mit übereinstimmenden und nichtübereinstimmenden Antworten.

Ergebnisse:

20 (16,1%) Patienten konnten überhaupt keine Angaben zu ihren Schmerzen machen. Die ärztliche Einschätzung der Schmerzsituation unterschied sich nicht von den Patienten, die Auskunft geben konnten. Bei 25 (20,3%) Patienten schätzten die Ärzte die Schmerzsituation falsch ein. Bei 14 (11,3%) Patienten konnten sich die Ärzte zu Schmerzen in den letzten 7 Tagen nicht festlegen. Insgesamt waren am Untersuchungstag 13/46 (28,3%) Patienten mit Schmerzen unzureichend schmerztherapeutisch behandelt.

Schlussfolgerungen:

Die Schmerzsituation ist bei der Hälfte stationärer, geriatrischer Patienten dem behandelnden Arzt nur ungenügend bekannt oder schwierig zu erkennen. Die Bedeutung der Schmerztherapie in der Geriatrie wird u. a. daran deutlich, dass am Untersuchungstag fast jeder 3. Schmerzpatient “noch” unbefriedigend behandelt war.

Abstract

Objective:

Elderly people often present substantial problems in pain assessment. The aim of the study was to quantify and discuss the problem of recognizing pain in hospitalized geriatric patients.

Methods:

124 geriatric patients and their treating doctors were questioned about pain, pain intensity and influence of pain on daily living in a cross-sectional-study. The score of the Barthel index (activity of daily living, ADL) at admittance and discharge, the cognitive status (minimental status of Folstein, MMS), the use of analgetic drugs and the medical diagnoses were assessed. The answers of the question “Did you/your patient have pain in the past seven days?” from patients and doctors were used to make seven groups.

Results:

20 (16,1%) patients could not answer the question about pain. In comparison to the group of patients who were able to answer, they were restricted in ADL and MMS. However, the answers of doctors about pain did not differ. 25 (20,3%) answers of treating doctors were wrong compared to the answers of the patients. In these cases, intensity and influence of pain on daily living were estimated low by the patients. In 14 (11,3%) patients, doctors could not state about pain. These patients were least restricted in ADL at admission and discharge. Altogether, the pain of 13/46 (28,3%) patients was treated insufficiently at the day of the interview.

Conclusions:

In half of the geriatric patients, pain was not well or not at all recognized by the treating doctors. Pain of not communicative patients was assessed similarly by the doctor as that of patients who were able to give information. In this geriatric hospital, little support at admittance and a superior improvement in the activities of daily living during the in-hospital treatment lead to less attention to pain by the doctor. The importance of pain therapy in geriatrics is illustrated by the fact that almost every third patient with pain is treated insufficiently at the day of the interview.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schuler, M., Hestermann, M., Hauer, K. et al. Probleme bei der Erkennung von Schmerzen in der Geriatrie. Schmerz 16, 171–178 (2002). https://doi.org/10.1007/s00482-002-0143-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00482-002-0143-4

Navigation