| Title |
The relative meaning of absolute numbers: the case of pain intensity scores as decision support systems for pain management of patients with dementia
|
|---|---|
| Published in |
BMC Medical Informatics and Decision Making, December 2015
|
| DOI | 10.1186/s12911-015-0233-8 |
| Pubmed ID | |
| Authors |
Valentina Lichtner, Dawn Dowding, S. José Closs |
| Abstract |
Assessment and management of pain in patients with dementia is known to be challenging, due to patients' cognitive and/or communication difficulties. In the UK, pain in hospital is managed through regular assessments, with the use of pain intensity scores as triggers for action. The aim of this study was to understand current pain assessment practices, in order to later inform the development of a decision support tool designed to improve the management of pain for people with dementia in hospital. An exploratory study was conducted in four hospitals in the UK (11 wards), with observations of patients with dementia (n = 31), interviews of staff (n = 52) and patients' family members (n = 4) and documentary analysis. A thematic analysis was carried out, structured along dimensions of decision making. This paper focuses on the emergent themes related to the use of assessment tools and pain intensity scores. A variety of tools were used to record pain intensity, usually with numerical scales. None of the tools in actual use had been specifically designed for patients with cognitive impairment. With patients with more severe dementia, the patient's body language and other cues were studied to infer pain intensity and then a score entered on behalf of the patient. Information regarding the temporality of pain and changes in pain experience (rather than a score at a single point in time) seemed to be most useful to the assessment of pain. Given the inherent uncertainty of the meaning of pain scores for patients with dementia, numerical scales were used with caution. Numerical scores triggered action but their meaning was relative - to the patient, to the clinician, to the time of recording and to the purpose of documenting. There are implications for use of data and computerized decision support systems design. Decision support interventions should include personalized alerting cut-off scores for individual patients, display pain scores over time and integrate professional narratives, mitigating uncertainties around single pain scores for patients with dementia. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 3 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 111 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Japan | 1 | <1% |
| United Kingdom | 1 | <1% |
| Spain | 1 | <1% |
| United States | 1 | <1% |
| Unknown | 107 | 96% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 20 | 18% |
| Student > Master | 19 | 17% |
| Student > Ph. D. Student | 11 | 10% |
| Student > Doctoral Student | 5 | 5% |
| Researcher | 5 | 5% |
| Other | 24 | 22% |
| Unknown | 27 | 24% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 28 | 25% |
| Medicine and Dentistry | 22 | 20% |
| Psychology | 10 | 9% |
| Social Sciences | 5 | 5% |
| Agricultural and Biological Sciences | 2 | 2% |
| Other | 13 | 12% |
| Unknown | 31 | 28% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 March 2022.
All research outputs
#13,271,144
of 23,381,576 outputs
Outputs from BMC Medical Informatics and Decision Making
#895
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Outputs of similar age
#181,170
of 393,400 outputs
Outputs of similar age from BMC Medical Informatics and Decision Making
#23
of 43 outputs
Altmetric has tracked 23,381,576 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,022 research outputs from this source. They receive a mean Attention Score of 5.0. This one has gotten more attention than average, scoring higher than 53% of its peers.
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We're also able to compare this research output to 43 others from the same source and published within six weeks on either side of this one. This one is in the 46th percentile – i.e., 46% of its contemporaries scored the same or lower than it.