Undermedication for pain and precipitation of delirium

Medsurg Nurs. Mar-Apr 2010;19(2):79-83; quiz 84.


Introduction: Review of the literature revealed an association of pain and delirium in patients with hip fracture. Literature was sparse on pain and delirium in other types of patients.

Purpose: The purpose of this study was to determine if there was a difference in the amount of analgesia received by patients in pain who developed delirium compared with those who did not develop delirium.

Method: A sample of 43 medical-surgical patients who were hospitalized with pain and who developed delirium was compared with a matched group of 43 medical-surgical patients with pain who did not develop delirium. The percentage of allowed analgesia received by each group was examined.

Findings: The dependent variable of "percentage of allowed analgesia received" was significantly different between the two groups. The mean percentage of analgesia received by those who developed delirium was 26.14% while the mean percentage of analgesia of those who did not develop delirium was 48.21%.

Conclusion: The results revealed an association between low dose of analgesia and development of delirium for patients who are in pain. Nurses can increase their focus on adequate pain management for older patients.

MeSH terms

  • Aged, 80 and over
  • Analgesia / nursing
  • Analgesia / statistics & numerical data*
  • Analysis of Variance
  • Case-Control Studies
  • Causality
  • Comorbidity
  • Delirium / epidemiology
  • Delirium / etiology*
  • Female
  • Geriatric Assessment
  • Humans
  • Inpatients / statistics & numerical data
  • Male
  • Midwestern United States / epidemiology
  • Mobility Limitation
  • Nursing Assessment
  • Nursing Audit
  • Nursing Evaluation Research
  • Pain / complications*
  • Pain / diagnosis
  • Pain / drug therapy*
  • Pain Measurement