Pain and Associated Factors in Nursing Home Residents.
Connie S Cole, Justin Blackburn, Janet S Carpenter and 2 others
PMID 37003932WHAT IT FOUND
Nursing home residents with intact cognition, arthritis, depression, anxiety, or contractures were more likely to report severe or persistent pain.
Residents with Alzheimer’s disease reported less pain, likely due to assessment difficulties rather than lower pain levels.
Key findings
01Residents with intact cognition had significantly higher odds of reporting moderate to severe or frequent pain compared to those with severe impairment, while those with Alzheimer's disease were less likely to report pain.
02Persistent pain was associated with younger age, Black race, rural residence, intact cognition, contractures, and depression.
03Non-pharmacological pain treatments were received by only 35.6% of residents with moderate to severe pain and 39.5% of those with persistent pain.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
The cross-sectional design prevents conclusions about causality. The sample came from facilities involved in a geriatric care enhancement project, which may limit generalizability to typical nursing homes. Data collection occurred between 2011 and 2019, so current pain management practices may differ. Pain scales may be unreliable in older adults, particularly those over 81 or with cognitive impairment. Use of proxy reports for residents unable to self-report increases the risk of under-identifying pain.
Declared interests
The authors declared no conflicts of interest. One author (Janet S. Carpenter) reported past and ongoing relationships with specific research organizations, but these were not described as conflicts of interest.
The easy way to misread this
Do not interpret lower pain reports in residents with Alzheimer's disease as evidence they experience less pain. The study suggests this is likely due to difficulties in self-reporting and proxy assessment, meaning these residents may be under-treated for pain.