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Problemfelder in der Schmerzmessung und Schmerztherapie im Alter

Problems of pain measurement and pain therapy in the elderly

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Summary

Due to complex physical and psychological changes in aging, pain measurement and therapeutic treatment of older and geriatric patients present a special challenge. Nevertheless, even for this category of patients, good treatment results are achievable if age-related particulars and problems are consistently heeded and accounted for. That includes adverse sensory and cognitive effects as much as multimorbidity and the polypharmacy that is frequently related to it. An essential prerequisite for adequate pain therapeutic care in elderly patients is consistent pain measurement. While numerical and verbal scales have also proven their usefulness for patients in advanced age who are not cognitively impaired, instruments must be applied for older people with communicative and/or cognitive restrictions with which the observed behavior of those involved can be surveyed in a multidimensional way.

Zusammenfassung

Aufgrund komplexer physischer und psychischer Veränderungen im Alter stellen die Schmerzmessung und Schmerztherapie für ältere und betagte Patienten besondere Herausforderungen dar. Doch auch bei dieser Gruppe von Patienten sind gute Behandlungserfolge erreichbar, wenn altersbedingte Spezifika und Probleme konsequent beachtet und berücksichtigt werden. Dazu gehören sensorische und kongnitive Beeinträchtigungen ebenso wie die Multimorbidität und die damit häufig verbundene Polypharmazie. Eine wesentliche Voraussetzung für eine adäquate schmerztherapeutische Versorgung älterer Patienten ist die konsequente Schmerzmessung. Während numerische und verbale Skalen auch für kognitiv nicht beeinträchtigte Patienten im fortgeschrittenen Alter ihre Zweckmäßigkeit unter Beweis gestellt haben, müssen für ältere Menschen mit kommunikativen und/oder kognitiven Einschränkungen Instrumente eingesetzt werden, mit denen das beobachtete Verhalten der Betroffenen mehrdimensional erhoben werden kann.

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Authors and Affiliations

  1. Haus der Geriatrie, Landeskrankenhaus Klagenfurt, Klagenfurt, Austria

    Georg Pinter

  2. Abteilung für Anästhesiologie und Intensivmedizin, Landeskrankenhaus Klagenfurt, Klagenfurt, Austria

    Rudolf Likar

  3. Klinische Pharmazie, Sozialmedizinisches Zentrum Ost, Donauspital, Wien, Austria

    Martina Anditsch

  4. Abteilung für Psychiatrie und Psychosomatik, Landeskrankenhaus Steyr/Enns, Steyr/Enns, Austria

    Michael Bach

  5. ehem. ärztlicher Leiter des Sozialmedizinisches Zentrum Sophienspital der Stadt Wien, Wien, Austria

    Franz Böhmer

  6. Abteilung für orthopädische Schmerztherapie, Orthopädisches Spital Speising, Wien, Austria

    Martin Friedrich

  7. Abteilung für Akutgeriatrie, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Wien, Austria

    Thomas Frühwald

  8. Abteilung für Innere Medizin, Landeskrankenhaus Hochzirl, Zirl, Austria

    Markus Gosch

  9. Geschäftsführung der Hilfswerk Personaldienstleistungs-GmbH, Wien, Austria

    Monika Gugerell

  10. Abteilung für Neurologie II mit Schmerzmedizin, Krankenhausus der Barmherzigen Brüder, Linz, Austria

    Christian Lampl

  11. Abteilung für Psychotherapie und Psychiatrie, Landeskrankenhaus Klagenfurt, Klagenfurt, Austria

    Josef Marksteiner

  12. Institut für Pathophysiologie, Medizinische Universität Wien, Wien, Austria

    Peter Pietschmann

  13. Sozialmedizinisches Zentrum Sophienspital der Stadt Wien, Wien, Austria

    Katharina Pils

  14. Universitätsklinik für Innere Medizin I, Medizinische Universität Innsbruck, Innsbruck, Austria

    Michael Schirmer

Authors
  1. Georg Pinter
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  2. Rudolf Likar
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  3. Martina Anditsch
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  4. Michael Bach
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  6. Martin Friedrich
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  7. Thomas Frühwald
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  8. Markus Gosch
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  9. Monika Gugerell
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  10. Christian Lampl
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  11. Josef Marksteiner
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  12. Peter Pietschmann
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  14. Michael Schirmer
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Correspondence to Rudolf Likar.

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Pinter, G., Likar, R., Anditsch, M. et al. Problemfelder in der Schmerzmessung und Schmerztherapie im Alter. Wien Med Wochenschr 160, 235–246 (2010). https://doi.org/10.1007/s10354-010-0797-y

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  • DOI: https://doi.org/10.1007/s10354-010-0797-y

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