Differences between nurses' and care workers' estimations of pain prevalence among older residents

A high prevalence of pain and difficulties with pain assessment has been widely reported among residents of long-term-care facilities. We explored nurses' and care workers' estimations of residents' pain (both general and chronic) and the number of residents with unknown pain status. We also examined the relationship between the prevalence of pain and assessment strategies undertaken by nurses and care workers. A cross-sectional design was used. Nurses and care workers across 750 long-term care facilities in four Japanese prefectures were asked to participate. Questionnaires were administered to one nurse and care worker at each facility. The questionnaires assessed the estimated numbers of residents who had pain in general, chronic pain, or unknown pain status on the day of data collection, and pain assessment strategies use by the health care professionals. In all, 263 (17.5%) questionnaires were returned from 147 nurses (55.9%) and 116 care workers (44.1%). The nurses' and care workers' median estimations of pain and chronic pain prevalence among residents were 11.6 and 9.4 and 29.4 and 15.5, respectively (p < .001). Estimations of pain prevalence were significantly higher among nurses who had observed signs of pain among residents in the previous month (p = .04) and who applied a multidisciplinary approach to pain assessment and management (p = .007) than among nurses who did not do either. Nurses and care workers had relatively low estimations of the prevalence of pain among their residents. Staff should undertake appropriate and sufficient pain assessments in order to improve their understanding of residents' pain.