Demographics, Psychological Distress, and Pain From Pressure Injury.

This was a cross-sectional secondary analysis of electronic records, so it cannot show that any factor caused pain, distress, or pressure-injury severity. Psychological distress was not measured directly; it was inferred from antidepressant, anxiety, and sleep medication records, so untreated distress could be missed and medication effects could distort the associations. The sample came from one regional acute hospital and was limited to White patients and other races, so results may not generalize. Pain and medication data were taken from only the third day of admission over 24 hours, so they may not represent the whole stay. Patients with other wounds, surgery before the third day, low Glasgow coma scale verbal response, consecutive admissions, or unavailable data were excluded, so the final 454 patients may not represent all pressure-injury patients. Only pressure-injury stages 1 through 4 were examined; deep tissue and unstageable injuries were excluded, and the number and location of injuries were not counted. Comorbidities were counted only by number, not by type, so different conditions were treated as equivalent. 34.88% of participants had a pain score of 0, and the paper notes that such a variable with many zeros may inflate effects.

The authors reported no conflicts of interest. The article is listed as NIH extramural research support.

Do not conclude that a more advanced pressure injury means more pain or more distress. The analysis found no significant direct or indirect links between injury stage, psychological distress, and pain, and distress was inferred from medication records rather than measured directly.