Grażyna Puto

Introduction: Chronic pain in older people is a global health problem not only in terms of a negative subjective feeling, but also as a social and economic factor. Deterioration of functional capacity is one of the main symptoms of chronic pain; therefore, it should be assessed as a basic parameter in the life of older people. The aim of the study was to analyze the factors which have an impact on the functional capacity of older people with chronic pain. Material and methods: The study was conducted among 181 people over 65 suffering from chronic pain lasting more than 6 months. The study used a questionnaire that included questions about demographic and social characteristics and the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Pain Measure-24 (GPM-24). Results: In the study group, a positive correlation was found between: coexisting diseases and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A positive correlation was also found between the Geriatric Depression Scale (GDS) and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A significantly negative correlation was found between: AMTS, ADL, IADL performance and: withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of total GPM-24 score. Conclusions: Chronic pain is more common in people with disabilities in basic and complex activities of daily living, with limited efficiency in cognitive functions and an increased sense of depression. The standard in everyday practice and clinical trials should be taking a history of chronic pain in every older person, monitoring the pain’s intensity and accompanying characteristics by using a multidimensional scale for assessing pain in older people.

Narracja i realizowana w oparciu o nią opieka narracyjna umożliwia włączenie do codziennej praktyki klinicznej perspektywy humanistycznej odwołującej się do opowieści (narracji) pacjentów i ich bliskich, a także personelu medycznego. Połączenie wiedzy pochodzącej z narracji oraz kontekstu klinicznego i uwarunkowań realizowanej opieki pozwala na skupienie się na jednostkowych potrzebach i wyjątkowości każdego człowieka. Narracja może być także postrzegana jako jedna z form etyki. U podstaw etyki narracyjnej leży założenie, że narracja jest istotnym elementem wpływającym na podejmowane w sytuacjach klinicznych decyzje, również te związane z rozwiazywaniem dylematów etycznych. Etyka narracyjna pomaga docenić wpływ historii (opowieści) na jaźń oraz zrozumieć bogactwo i złożoność indywidualnego życia, a tym samym może stanowić podstawę dla rozumowania etycznego. Ze względu na specyfikę roli zawodowej pielęgniarki etyka narracyjna może stanowić istotną wartość wykorzystywaną w nauczaniu etyki zawodu. Celem pracy jest przedstawienie wybranych zagadnień związanych z etyką narracyjną w kształceniu pielęgniarek. ABSTRACT The role of narrative ethics in nursing education Narrative and narrative care enables the integration of a humanistic perspective into everyday clinical practice, referring to the stories (narratives) of patients and their relatives, as well as medical personnel. The combination of knowledge derived from narrative and the clinical context and determinants of the care provided allows to focus on the individual needs and uniqueness of each person. Narrative can also be perceived as a form of ethics. At the core of narrative ethics is the assumption that narrative is an essential element that influences decisions made in clinical situations, including those related to resolving ethical dilemmas. Narrative ethics helps to appreciate the impact of stories (storytelling) on the self and to understand the richness and complexity of individual lives, and thus can provide a basis for ethical reasoning. Given the specificity of the professional nurse’s role, narrative ethics can be an important value used in teaching professional ethics. The aim of this paper is to present selected issues related to narrative ethics in the professional education of nurses.