Pain efficacy in home hospice patients. A longitudinal study

A descriptive, retrospective study was conducted to determine pain intensity in 30 home hospice patients identified with pain problems. Charts were reviewed, from admission to death, for numerical pain intensity ratings, changes in the route of administration, and/or changes in medication/scheduling. Patients were grouped into three categories according to their pattern of pain as follows: (a) Group I, 20 patients who had a pattern of increasing pain, a significant lowering of the pain intensity means, and frequent changes in pain management; (b) Group II, seven patients who showed little or no increase in pain; and (c) Group III, three patients who showed a decreased intake of pain medication. In contrast to Group I, both Groups II and III demonstrated few route changes, received few pain intensity ratings, and were maintained on oral medications through death. Based upon the nurses' pain intensity ratings and frequent interventions, a t test of admission and final means demonstrated a significant lowering of pain intensity, over time, for 15 patients in Group I who received consistent pain ratings.