Information Model on pain management for elder adults aged 75 years or older.
Ana Clara de Brito Cruz, Amália de Fátima Lucena, Aline Tsuma Gaedke Nomura and 1 others
PMID 39476132WHAT IT FOUND
Hospital records of older adults showed pain care mostly under acute pain diagnoses, relying on single-score pain scales and missing multidimensional assessment.
Nurses may need to document pain, mobility, and fall risk more comprehensively.
Key findings
01Pain-related nursing care was recorded mostly under acute pain (73.7%), then chronic pain (9.5%), risk of falls (8.9%), impaired comfort (4.8%), and impaired physical mobility (1.7%).
02The information model grouped pain-related records into seven attribute sets and assessment, intervention, nursing diagnosis, and reassessment panels.
03Hospital records showed unidimensional pain intensity scales in use and no multidimensional pain instruments.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used only structured electronic records and excluded free-text nursing notes, history, and physical examination, so it may miss pain descriptions or reasons for care. It was built from one hospital's records, so it may not reflect other settings. The information model was not validated and cannot show that it improves pain care. It was descriptive; it cannot prove that pain causes falls or that any treatment works. Patient counts differ between the sample section and results: 7,453 patients are stated in the sample, while results report 4,753 patients. Data extraction and programming were done by one researcher, which can introduce errors. Secondary electronic records may contain recording errors or missing dates, including hospitalization dates used to determine age.
Declared interests
The work was supported by Brazilian public research funding (CNPq and CAPES) and was part of a PAHO/WHO nursing research collaboration. The paper does not report commercial funding or author conflicts of interest.
The easy way to misread this
Do not treat this as a validated pain-management tool or proof that pain causes falls. It describes structured hospital records from one institution and the model has not been validated.