The Relationship Between Pain, Function, Behavioral, and Psychological Symptoms of Dementia and Quality of Life.
Barbara Resnick, Elizabeth Galik, Ann Kolanowski and 8 others
PMID 34353739WHAT IT FOUND
In nursing home residents with severe dementia, observed pain was linked to lower daily function, more agitation, more depressive symptoms, more resistance to care, and worse quality of life.
This was association only; the model fit poorly, and pain treatment was not tested.
Key findings
01Higher observed pain was associated with lower function, more agitation, more depressive symptoms, more resistiveness to care, and worse quality of life.
02Only 5% of residents were receiving opioids, and opioid use was not significantly associated with pain or quality of life.
03The revised model still fit poorly, with a chi-square divided by degrees of freedom of 57.91 and an RMSEA of .32.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary analysis of baseline data, not a randomized trial or intervention study, so it cannot show that pain caused the symptoms or that treating pain would improve them. The structural model fit poorly, so the reported relationships are not a well-supported model. All assessments relied on chart review, observation, and staff reports, which may be biased, especially for pain and behavioral symptoms. Participants had severe cognitive impairment and could not reliably self-report pain; proxies consented, and many eligible residents refused or could not assent, which may bias the sample. Opioid use was very low, so the lack of association between opioids and pain or quality of life may reflect few people receiving them. Pain was measured with an observational scale whose items may reflect behaviors not caused by pain.
Declared interests
The supplied publication types indicate NIH extramural research support. The provided text does not include an explicit author conflicts-of-interest statement.
The easy way to misread this
Do not conclude that treating pain improves function, behavior, or quality of life. The study was correlational, the model fit poorly, and pain treatment was not tested.