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Pain reports by older adults in long-term care: a pilot study of changes over time
Margaret C Gibson1, M Gail Woodbury, Kim Hay
1Veterans Care Program, Parkwood Hospital, St Joseph's Health Care London, London, Ontario, Canada. Maggie.gibson@sjhc.london.on.ca
Purpose:
To document self-reported pain descriptions throughout residency in a long-term care facility for a convenience sample of older adults (Canadian war veterans).
Design And Methods:
The present study was a longitudinal, fixed-cohort study with anticipated attrition. Participants (n = 33) were assessed every three months from admission until attrition or end of study (three years). The assessments included standardized measures of psychosocial functioning and a comprehensive pain questionnaire for residents who reported a pain problem.
Results:
On average, respondents completed five assessments before attrition and reported pain in 69% of assessments. The likelihood of pain report decreased as the number of assessments increased. Cross-sectional analysis indicated that, at admission, pain duration was greater and nonverbal pain expression less prominent than later in residency. Longitudinal analysis indicated greater than 50% within-subject variability across three consecutive pain reports for nonpharmacological pain relief, pain expression and functional impact of pain.
Conclusion:
The present study highlights the need for patient-centred, longitudinal investigations of both the natural progression of pain and environmental factors that mediate pain management in the interests of improving pain control for this population.
