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Pain in U.S. nursing homes: validating a pain scale for the minimum data set.
B E Fries1, S E Simon, J N Morris
1Institute of Gerontology and School of Public Health, University of Michigan, and Ann Arbor VA Medical Center, 48109-2007, USA. bfries@umich.edu
The Gerontologist
|May 1, 2001
Summary
A validated pain scale for the Minimum Data Set (MDS) assessment shows pain is common in nursing home residents. Pain prevalence increases with cognitive impairment, indicating a need for better pain management strategies.
Area of Science:
- Gerontology
- Pain Management
- Health Informatics
Background:
- Pain is a significant issue in nursing home residents.
- Accurate pain assessment is crucial for effective management.
- The Minimum Data Set (MDS) is a key assessment tool in long-term care.
Purpose of the Study:
- To validate a pain scale for the MDS assessment instrument.
- To determine the prevalence of pain in nursing home subpopulations.
- To investigate the relationship between pain, type of admission, and cognitive status.
Main Methods:
- Validation of MDS pain items against the Visual Analogue Scale (VAS).
- Utilized Automatic Interaction Detection for scale derivation.
- Retrospective analysis of 34,675 Michigan nursing home residents.
Main Results:
- The four-group scale demonstrated high validity, explaining 56% of the variance in VAS pain scores.
- Only 47% of postacute patients and 63% of postadmission patients reported no pain.
- Pain prevalence increased with cognitive impairment.
Conclusions:
- Pain is highly prevalent among nursing home residents.
- Cognitive dysfunction is associated with increased pain prevalence.
- A significant portion of pain in this population remains untreated.
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