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

Abstract

Objectives: To determine the extent to which pain is associated with well-being indices among nursing home residents.

Design: Cross-sectional.

Setting: A total of 185 for-profit nursing homes from 19 states.

Participants: Participants were 9952 long-stay residents without cancer.

Measurements: 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: Twenty-five 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.

Conclusion: 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.