Psychosocial interventions for pain management in older adults with dementia: A systematic review of randomized controlled trials

Aim: To assess the effectiveness of psychosocial interventions on pain in older adults living with dementia. Design: A systematic review with meta-analysis of randomized controlled trials. Data sources: Scopus, ProQuest, EBSCO (CINAHL and MEDLINE), PubMed, OVID (PsycINFO), Web of Science, and Cochrane Library were searched from their inception up to 2 May 2018. Review Methods: Risk of bias assessment and meta-analysis were conducted according to the Cochrane methods using RevMan 5.3 and findings were generated using the GRADE profiler software. Results: Eight studies met the inclusion criteria, but the quality of the current evidence was low to moderate. Results showed that psychosocial interventions significantly reduced the observational pain score and pain medication. Subgroup analyses indicated that sensory stimulation and individual interventions showed a reduction in observational pain in people with dementia. Conclusion: Findings suggest that psychosocial interventions may be potentially effective alternatives for pain management in people with dementia. However, caution is needed in interpreting these results due to limited studies, risk of bias and heterogeneity across studies. Furthermore, well-designed research is needed on psychosocial interventions to strengthen quality of pain management in people with dementia. Impact: This review synthesized current evidence using psychosocial interventions to manage pain in people with dementia. Findings suggest that psychosocial interventions may lead to a potential reduction in pain and pain medication in people with dementia. Healthcare providers may wish to integrate psychosocial interventions as part of the multimodal approach to the management of pain in people living with dementia.No Full Tex

The partnering with patients model of nursing interventions : A first step to a practice theory

The development of a body of knowledge, gained through research and theory building, is one hallmark of a profession. This paper presents the “Partnering with Patients Model of Nursing Interventions”, providing direction towards how complex nursing interventions can be developed, tested and subsequently adopted into practice. Coalescence of understanding of patient-centred care, the capabilities approach and the concept of complex healthcare interventions led to the development of the model assumptions and concepts. Application of the model to clinical practice is described, including presentation of a case study, and areas for future research including understanding both patients’ and nurses’ perceptions and experiences when the model is in use, and testing the effect of nursing interventions based on the model are recommende