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Heart Failure: The Hidden Problem of Pain
Journal of Pain and Symptom Management, 09/08/09

Goebel JR et al. – This study assessed pain in HF and identified contributing factors. The association of physical, psychological, social, and spiritual domains with pain suggests that multidisciplinary interventions are needed to address the complex nature of pain in HF.

Methods

As part of a multicenter study, 96 veterans with HF (96% male, 67±11 years) completed measures of symptoms, pain (Brief Pain Inventory [BPI]), functional status (Functional Morbidity Index), and psychological state (Patient Health Questionnaire–2 and Generalized Anxiety Disorder–2).
Single items from the BPI interference and the quality of life–end of life measured social and spiritual well–being.
Demographic and clinical variables were obtained by chart audit.
Correlation and linear regression models evaluated physical, emotional, social, and spiritual factors associated with pain.

Results

55.2% HF patients reported pain, with a majority (37.5%) rating their pain as moderate to severe (pain>=4/10).
The presence of pain was reported more frequently than dyspnea (71.3% vs. 61.7%).
Age, psychological (depression, anxiety), social, spiritual, and physical (health status, symptom frequency, functional status) well–being were correlated with pain severity.
In the resulting model, 38% of the variance in pain severity was explained; interference with relations and symptom number contributed to pain severity.

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