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Pain in Advanced Stages of Dementia: The Perspective of Medical Students

Authors :: Sławomir Tobis
Katarzyna Wieczorowska-Tobis
Agnieszka Neumann-Podczaska
Lyudmila Yermukhanova
Source :: Medicina, Volume 55, Issue 5, Medicina, Vol 55, Iss 5, p 116 (2019), Medicina; Volume 55; Issue 5; Pages: 116
Publication Year :: 2019
Publisher :: MDPI AG, 2019.
Abstract: Background and objective: The number of studies related to medical students&rsquo attitude toward pain is limited. The aim of our study was, thus, to assess the medical students&rsquo knowledge of pain assessment and treatment in advanced stages of dementia in order to improve the existing curriculum in this area. Material and methods: We analyzed the medical students&rsquo knowledge about pain in advanced dementia based on a short questionnaire. The research was anonymous. The questionnaire was completed by 147 students. Results: The students most often suggested that pain in patients with advanced dementia could be manifested via body language and facial expression (107 students&mdash 72.8% and 100 students&mdash 68.0%, respectively). Vocalization was the third most frequently reported pain manifestation (84&ndash 57.1%). Other groups of pain symptoms (changes in activity patterns, changes in interpersonal interactions, and mental status changes) were indicated less often (p &lt 0.0001). Only five students (3.4%) listed the DOLOPLUS behavioral pain scale as an assessment tool for patients with advanced dementia, and 16 (10.9%) indicated observational scale elements or a necessity to observe the patient. Still, 110 students (74.5%) correctly characterized pain treatment in patients with advanced dementia. Conclusions: To the best of our knowledge, our study is pioneering in defining the deficits of medical students&rsquo knowledge on pain assessment and treatment in patients with advanced dementia. We highlighted knowledge gaps in the area of pain assessment which might make medical students incapable of proper pain treatment. Following the International Association for the Study of Pain considerations regarding the need for excellence in pain education, these results can contribute to the improvement of existing medical curricula in Poznan University of Medical Sciences to include pain management in dementia in a more &rdquo patient-centered&rdquo way in order to increase future staff&rsquo s competency and to assure a better quality of care.