Unacknowledged afflictions : the essentials of the experience of people with persistent pain in nursing homes
Bibliographic record
Abstract
Persistent pain among the elderly is a major health problem within nursing homes.There is new knowledge, mainly in pharmacology, on pain assessment and management of this age group.Geriatricians claim that with quality pain management a relevant goal is to provide considerably relief and in some cases a pain-free state of those that now suffer.Certain attitudes of the elderly are known to bias pain assessment.The purpose of this study was to examine the lived experience of elderly residents with persistent pain in nursing homes.The research approach used was the Vancouver school of doing phenomenology.Data were collected in open interviews or dialogues.The research question was: 'What are the essentials of the experience of people with persistent pain in nursing homes'?The sample was twelve residents, mean age 86 years.After analysing the transcribed data, themes were constructed.The overriding theme was is 'Unacknowledged afflictions'.Three major themes were constructed.The first theme: Reconciliation to losses in life refers to the fact that residents tended to see their pain in a wider perspective of losses in life.They reiterated losses of loved ones, of health and former home An ongoing work of reconciliation and adjustment seemed to be going on within them, many could be placed on a continuum between grief and even anger at one end genuine peace on the other.The second theme was: the lived experience of persistent pain with the subthemes of : All in control, Seeks help when needed and Reluctant to seek help.Some felt everything was under control and of which the doses of tablets seemed to be a token.Others had no problem with seeking help when needed.One resident did seek help in vein.A few were reluctant to seek help and seemed to have become lost or unacknowledged from the eyes of the doctors or nurses.This seems a group in obvious need for help.The third major theme was: Sources of strength and joy.These were mainly close relatives, enjoying reasonably good health and conditions of living.Suggestion is made that nurses will look at persistent pain in the aged in the context of the multiple losses and grief.Residents without needed help must be found.Under all circumstances should the words of the sufferer be counted as valid.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.008 | 0.022 |
| Scholarly communication | 0.006 | 0.006 |
| Open science | 0.002 | 0.007 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".