Pain experience and management in a forensic intellectual disability service
| Published date | 03 March 2014 |
| Date | 03 March 2014 |
| Pages | 120-127 |
| DOI | https://doi.org/10.1108/AMHID-03-2013-0026 |
| Author | Verity Chester,Marie Henriksen |
| Subject Matter | Health & social care,Learning & intellectual disabilities,Accounting education |
Pain experience and management in a
forensic intellectual disability service
Verity Chester and Marie Henriksen
Verity Chester is a Research
Assistant and Marie Henriksen
is a Practice Nurse, both are
based at Partnerships in Care
Learning Disability Services,
Norfolk, UK.
Abstract
Purpose – Research investigating the experience and management of pain in people with intellectual
disabilities has mainly been carried out in community services. The purpose of this baseline audit aims to
examine this area in a forensic intellectual disability setting.
Design/methodology/approach – A baseline audit of pain management was carried out. Audit standards
were derived from recent research, and the performance on each measured. Patients and nurses were
interviewed. The audit included 82 patients, of which 64 were interviewed. Twelve nurses were interviewed.
Health Action Plans and medication files were accessed for information.
Findings – There were interesting differences and similarities in the experience and management of pain
between community and forensic intellectual disability patients. Within this sample, most patients were able
to communicate their pain, and access appropriate treatment. However,a minority required further support.
Nurse decision making about providing pain treatment was affected by fears of manipulation, contributing
to addition and disbelieving the patient. Additionally, a number of patients appeared to have insufficient
knowledge about how to best manage pain.
Practical implications – Results suggested that a standardised approach to pain management,
incorporating policy, staff training, and health promotion and psycho-education for patients, would have
benefits for both patients and staff within secure intellectual disability services.
Originality/value – At present, there is little research focusing on pain experience and management in
forensic intellectual disability settings.
Keywords Intellectual disability, Learning disability, Forensic, Mental disorder, Pain, Secure
Paper type Research paper
Introduction
People with intellectual disabilities generally experience pain more frequently, and to a higher
degree than the general population (Defrin et al., 2004). This is due to the physical health
conditions often associated with the disability, and the increased likelihood of experiencing
painful life events, such as surgery or assault (Symons et al., 2008). Despite this, people with
intellectual disabilities have historically been excluded from pain research, and there is a paucity
of empirical research in this area (Symons et al., 2008). Research has identified a number of
barriers with the effective identification and subsequent management of pain in this population.
In terms of identification, pain treatment is usually reliant on self-report from the person affected
(McGuire et al., 2010). However, the communication impairments associated with intellectual
disability often cause difficulty in verbally describing pain (Foley and McCutcheon, 2004; Findlay
et al., 2013). Although there are tools available to assist staff with identifying pain in those with
intellectual disabilities, these are not routinely used in services (Beacroft and Dodd, 2009).
People with intellectual disabilities sometimes ignore pain, and do not seek treatment, due
to concerns about bothering carers ( Turk et al., 2012). It has also been noted that pain
reports from people with intellectual disabilities are not always believed (Findlay et al., 2013).
PAGE 120
j
ADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
VOL. 8 NO. 2 2014, pp. 120-127, CEmeraldGroup Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-03-2013-0026
To continue reading
Request your trial