The association between pain and measures of well-being among nursing home residents

Journal of the American Medical Directors Association, 05/17/2012

In nursing home residents, pain is highly prevalent and affects measures of well–being. Initiatives to recognize and appropriately treat pain may lead to increased measures of well–being.

Methods

  • Cross–sectional.
  • A total of 185 for–profit nursing homes from 19 states.
  • Participants were 9952 long–stay residents without cancer.
  • Minimum Data Set assessments on pain; analgesics; and cognitive, functional, and emotional status.
  • Logistic regression models provided estimates of the association between persistent/intensified pain and intermittent pain on increases in depressed or anxious mood, reduced time involved in activities, resisting care, as well as verbal and physical aggression.

Results

  • 25 percent had pain documented on 2 consecutive assessments; these residents were more likely to have arthritis, an anxiety disorder, depression, or insomnia and less likely to have cognitive impairment than patients without pain.
  • Residents with persistent pain were 79% as likely to experience mood impairments (adjusted odds ratio [AOR]: 1.79; 95% confidence interval [CI]: 1.61–1.99) and 90% as likely to have less than one–third of time involved with activities (AOR: 1.90; 95% CI: 1.32–2.75) relative to those without pain.
  • Residents with intermittent pain were 30% as likely to experience mood impairments (AOR: 1.30; 95% CI: 1.18–1.45) and 55% as likely to have less than one–third of time involved with activities (AOR: 1.55; 95% CI: 1.08–2.23) relative to those without pain.
  • No association was observed with resisting care or verbal or physical aggression.

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