Fry et al 2015(b) AustraliaTitle Emergency nurses'perceptions of the role offamily/carers in caring forcognitively impaired olderpersons in pain: adescriptive qualitativestudyQualitative descriptivestudyPurposive samplingSee above (Fry et al,2015a)To understand EDnurses' perceptions ofthe role offamily/carers for oldercognitively impairedpersons experiencingpain as a result of along bone fractureFocus groups (4)Nvivo 9.2Thematic analysis(Gibbs, 2007)ED nurses perceivethat family members:were valuable inassisting staff to buildthe clinical picture onarrival in the ED; canprovide criticalinformation thatwould otherwise beunknown; reducenegative impact of theED environment onpatientIf family memberswere not present, thisadded to the workloadof nurses who couldnot deliver the carethe person with CIrequiredWorry and stress forfamily members. EDnurses expect familymembers to provideFamily members arethe hidden workforce.Collaboration betweenfamily members andnurses needs furtherexploration. Role offamily members in EDis sometimes unclearMore research neededto determine familymembers' perceptionsof emergency care23personal care but notall family members arecomfortable with this

Fry et al 2015(a) AustraliaEmergency nurses'perceptions of the role ofconfidence, self-efficacyand reflexivity inmanaging the cognitivelyimpaired older person inpainExploratory qualitativestudy. PurposivesamplingPart of a multicentrestudy that reportedfindings from 16 focusgroups across 4 EDsTo explore practice ofcare among ED nursescaring for older peoplewith cognitiveimpairment whopresented in pain froma long bone fractureFocus groups (4)Nvivo 9.2Thematic analysisCI is a barrier to painmanagement andoften leads tosuboptimal carebecause of lack ofverbal response. EDnurses need high levelsof confidence and self-Being confident andhaving self-efficacy canhelp ED nurses todevelop a moretherapeuticrelationship with theolder person with CIand their family22with 80 ED nurseparticipantsefficacy (ability to act)to initiate and deliverhigh-quality care forthis groupmembers. Confidenceand self-efficacy iscentral to caring and acompassionateapproach. Need foreducation and clinicalexposure to developconfidence and self-efficacy

Outline an example of how pain can often be overlooked or go underreported when working in aged and disability care.

Parke et al 2013 CanadaFacilitators and barriers tosafe emergencydepartment transitionsfor community-dwellingolder people withdementia and theircaregivers: a socialecological studyInterpretive,qualitative exploratorydesignPurposive samplingParticipants were: PWDplus familymember/carer (6)Carers (4) ED nurses(10) Nurse practitioners(4)To identify factors thatimpede/facilitate safetransitional care forPWD in the ED. Toidentify potentialsolutions that wouldsupport nurses toprovide sensitive careThree phases:interviews; creation ofa photographicnarrative journal;photo-elicitation focusgroups. Verbatimtranscription. NvivoConstant comparativeanalysisBeing under-triaged;time pressures; lack ofattention to basicneeds; feeling ignored,forgotten andunimportant. Triagesystem in the ED doesnot recognise atypicalpresentations—sets inmotion a cascade ofvulnerability of olderPWD. Family membersvalue the relationalaspects of care—recognition ofvulnerability,communication,interactions withnursesNurses should beadvocates forrelationship-centredcareNurses need supportto carry out bestpracticeDifficult to recruitolder people withdementia to the studybecause of effects ofdiseaseNeed for researchabout contextNeed for research thatfocuses on what workswell and wh

Outline how ageing and disability can impact pain.

The nurse is caring for a client reporting phantom limb pain after a below-the-knee amputation. The client is experiencing what type of pain?A. Perceived painB. Somatic painC. Neuropathic painD. Nociceptive pain