Association Between Modifiable Structural and Process Factors and the Quality Indicator Pain in Nursing Home Residents: A MultiCentre Cross-Sectional Survey.
Simone Baumgartner-Violand, Thekla Brunkert, Sinéad Cassidy and 3 others
PMID 39441541WHAT IT FOUND
In Swiss nursing homes, access to a geriatrician, a nursing expert, and better teamwork were linked to less resident pain.
A pain guideline was linked to less self-reported pain only. Access to a pain specialist was not.
Key findings
01Residents in institutions with access to a nursing expert had lower odds of self-reported pain (odds ratio 0.69) and observed pain (odds ratio 0.68).
02Access to a geriatrician was associated with lower odds of self-reported pain (odds ratio 0.81) and observed pain (odds ratio 0.77).
03Higher teamwork ratings among care workers were associated with lower odds of self-reported pain (odds ratio 0.73) and observed pain (odds ratio 0.64).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Because the study was cross-sectional, it cannot show that the factors caused less pain. The sample was a convenience sample of Swiss residential long-term care institutions, so results may not apply elsewhere. Not all institutions had implemented pain quality indicator measurement, so the analysed institutions may have been more interested in quality measurement. Care worker ratings of leadership, teamwork, and person-centred care were self-reported and could be influenced by social desirability. The study did not control for chronic conditions such as arthritis or diabetes, which can cause or worsen pain. A pain guideline being present did not show that it was used or implemented. The number analysed differed by outcome: 5368 residents for self-reported pain and 6047 for observed pain.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that adding a geriatrician, nursing expert, pain guideline, or better teamwork will reduce resident pain. This was a cross-sectional survey, so it can only show associations. It also did not test whether pain guidelines were used or whether residents had specific causes of pain.