Literature DB >> 23375521

Pain characteristics and pain control in European nursing homes: cross-sectional and longitudinal results from the Services and Health for Elderly in Long TERm care (SHELTER) study.

Albert Lukas1, Benjamin Mayer, Daniela Fialová, Eva Topinkova, Jacob Gindin, Graziano Onder, Roberto Bernabei, Thorsten Nikolaus, Michael D Denkinger.   

Abstract

OBJECTIVE AND
DESIGN: Few studies have compared cross-national characteristics of residents with pain in European long term care facilities. The SHELTER project, a cross-national European study on nursing home residents, provides the opportunity to examine this issue. The present study aimed to evaluate key figures about pain and compare them with seven European countries and Israel. SETTING, PARTICIPANTS, AND MEASUREMENTS: A total of 3926 nursing home residents were assessed by the interRAI instrument for Long Term Care Facilities (interRAI LTCF). Prevalence of pain, frequency, intensity, consistency, and control were estimated and compared cross-nationally. Correlates between patient-related characteristics and inadequate pain management were tested using bivariate and multivariate logistic regression models.
RESULTS: Overall, 1900 (48.4%) residents suffered from pain. Pain prevalence varied significantly among countries, ranging from 19.8% in Israel to 73.0% in Finland. Pain was positively associated with female gender, fractures, falls, pressure ulcers, sleeping disorders, unstable health conditions, cancer, depression, and number of drugs. It was negatively associated with dementia. In a multivariate logistic regression model, all associations remained except for sleeping disorders. Clinical correlations varied considerably among countries. Although in 88.1% of cases, pain was self-rated by the residents as sufficiently controlled, in only 56.8% of cases was pain intensity self-rated as absent or mild. Pain control and intensity improved within 1 year.
CONCLUSION: Pain prevalence is high and varies considerably across Europe. Although most residents considered pain as adequately controlled, a closer look confirmed that many still suffer from high pain intensities. Analyzing the reasons behind these differences may help to improve pain management.
Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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Year:  2013        PMID: 23375521     DOI: 10.1016/j.jamda.2012.12.010

Source DB:  PubMed          Journal:  J Am Med Dir Assoc        ISSN: 1525-8610            Impact factor:   4.669


  17 in total

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Review 10.  Neuroplasticity underlying the comorbidity of pain and depression.

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