Christine M Ulbricht1, Jacob N Hunnicutt2, Giovanni Gambassi3, Anne L Hume4, Kate L Lapane5. 1. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 2. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA; Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts, Worcester, Massachusetts, USA. 3. Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy. 4. University of Rhode Island College of Pharmacy, Kingston, Rhode Island, USA. 5. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA. Electronic address: kate.lapane@umassmed.edu.
Abstract
CONTEXT: Despite many nursing home residents experiencing pain, research about the multidimensional nature of nonmalignant pain in these residents is scant. OBJECTIVES: To identify and describe pain symptom subgroups and to evaluate whether subgroups differed by sex. METHODS: Using Minimum Data Set 3.0 data (2011-2012), we identified newly admitted nursing home residents reporting pain (n = 119,379). A latent class analysis included 13 indicators: markers for pain (i.e., severity, frequency, impacts sleep, and function) and depressive symptoms. Sex was evaluated as a grouping variable. Multinomial logistic models identified the association between latent class membership and covariates, including age and cognitive impairment. RESULTS: Four latent subgroups were identified: severe (15.2%), moderate frequent (26.4%), moderate occasional with depressive symptoms (26.4%), and moderate occasional without depressive symptoms (32.0%). Measurement invariance by sex was ruled out. Depressed mood, sleep disturbances, and fatigue distinguished subgroups. Age ≥75 years was inversely associated with belonging to the severe, moderate frequent, or moderate occasional with depressive symptoms subgroups. Residents with severe cognitive impairment had reduced odds of membership in the severe pain subgroup (adjusted odds ratio [aOR]: 0.84; 95% confidence interval [CI]: 0.78-0.90) and moderate frequent pain subgroup (aOR: 0.60; 95% CI: 0.56-0.64) but increased odds in the moderate occasional pain with depressive symptoms subgroup (aOR: 1.12; 95% CI: 1.06-1.18). CONCLUSION: Identifying subgroups of residents with different patterns of pain and depressive symptoms highlights the need to consider physical and psychological components of pain. Expanding knowledge about pain symptom subgroups may provide a promising avenue to improve pain management in nursing home residents.
CONTEXT: Despite many nursing home residents experiencing pain, research about the multidimensional nature of nonmalignant pain in these residents is scant. OBJECTIVES: To identify and describe pain symptom subgroups and to evaluate whether subgroups differed by sex. METHODS: Using Minimum Data Set 3.0 data (2011-2012), we identified newly admitted nursing home residents reporting pain (n = 119,379). A latent class analysis included 13 indicators: markers for pain (i.e., severity, frequency, impacts sleep, and function) and depressive symptoms. Sex was evaluated as a grouping variable. Multinomial logistic models identified the association between latent class membership and covariates, including age and cognitive impairment. RESULTS: Four latent subgroups were identified: severe (15.2%), moderate frequent (26.4%), moderate occasional with depressive symptoms (26.4%), and moderate occasional without depressive symptoms (32.0%). Measurement invariance by sex was ruled out. Depressed mood, sleep disturbances, and fatigue distinguished subgroups. Age ≥75 years was inversely associated with belonging to the severe, moderate frequent, or moderate occasional with depressive symptoms subgroups. Residents with severe cognitive impairment had reduced odds of membership in the severe pain subgroup (adjusted odds ratio [aOR]: 0.84; 95% confidence interval [CI]: 0.78-0.90) and moderate frequent pain subgroup (aOR: 0.60; 95% CI: 0.56-0.64) but increased odds in the moderate occasional pain with depressive symptoms subgroup (aOR: 1.12; 95% CI: 1.06-1.18). CONCLUSION: Identifying subgroups of residents with different patterns of pain and depressive symptoms highlights the need to consider physical and psychological components of pain. Expanding knowledge about pain symptom subgroups may provide a promising avenue to improve pain management in nursing home residents.
Authors: M A C Van Son; J De Vries; W Zijlstra; J A Roukema; T Gosens; M H J Verhofstad; B L Den Oudsten Journal: Qual Life Res Date: 2017-08-01 Impact factor: 4.147
Authors: Reynolds Morrison; Bill Jesdale; Catherine Dube; Sarah Forrester; Anthony Nunes; Carol Bova; Kate L Lapane Journal: J Pain Symptom Manage Date: 2020-08-31 Impact factor: 3.612