Sjuksköterskors upplevelser av att använda eller inte använda bedömningsinstrument vid smärtskattning av äldre personer i livets slutskede på kommunalt särskilt boende.- En kvalitativ intervjustudie

Sammanfattning: Abstract  Background: Pain is a common symptom in the end-of-life phase for older individuals residing in specialized housing in Sweden. The nurse's role is to alleviate pain and provide person-centered support to the individual and their family members during end-of-life care.   Objective: The aim of this study was to describe nurses' experiences of using or not using assessment tools for pain assessment in older individuals in the end-of-life stage in community-based specialized housing.   Method: The study employed a descriptive design with a qualitative inductive approach. Eight semi-structured interviews were conducted and analyzed using qualitative manifest and latent content analysis.   Main Findings: The results revealed that nurses used pain assessment instruments, but not consistently. The decision to use these instruments depended on factors such as the design of the instrument, the individual being assessed for pain, and the context in which the assessment took place. Nurses perceived the use of pain assessment instruments as providing a comprehensive picture and described them as useful tools for evaluating the effectiveness of pain relief interventions. However, many found the Abbey Pain Scale difficult to use when they were unfamiliar with the individual being assessed or if the individual had dementia. Adherence to team protocols was crucial for implementing pain assessment using these instruments. Lack of time and prevailing workplace culture were described as barriers to the use of pain assessment instruments.   Conclusion: Nurses should practice based on scientific evidence and proven experience. Not all older individuals in end-of-life care in community-based elderly housing receive pain assessments using validated assessment tools, despite research indicating that those who undergo pain assessment also experience better symptom relief. Effective relief of distressing symptoms such as pain is central to person-centered care.  Keywords: Community-based specialized housing, person-centered care, pain assessment instruments, end-of-life care, elderly