Hostname: page-component-7479d7b7d-8zxtt Total loading time: 0 Render date: 2024-07-13T17:32:26.617Z Has data issue: false hasContentIssue false
  • English
  • Français

Pain and its Association with Disability in Institutional Long-Term Care in Four Nordic Countries

Published online by Cambridge University Press:  29 November 2010

U. Harriet Finne-Soveri ,
Gunnar Ljunggren ,
Marianne Schroll ,
Pálmi V. Jónsson ,
Ingibjörg Hjaltadottir ,
Kiddy El Kholy  and
Reijo S. Tilvis
U. Harriet Finne-Soveri
Affiliation:
Koskela Hospital, Helsinki, Finland
Gunnar Ljunggren
Affiliation:
RAI Unit, Karolinska Institute and Stockholm County Council, Stockholm, Sweden
Marianne Schroll
Affiliation:
Department of Geriatrics HL, Kommunehospitalet, Copenhagen, Denmark
Pálmi V. Jónsson
Affiliation:
Department of Geriatrics, University of Iceland, Reykjavik, Iceland
Ingibjörg Hjaltadottir
Affiliation:
Reykjavik Hospital, Geriatric Centre, Reykjavik, Iceland
Kiddy El Kholy
Affiliation:
Benediktehjemmet, Copenhagen, Denmark
Reijo S. Tilvis
Affiliation:
Department of Medicine, Geriatric Division, University of Helsinki, Finland
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Cross-sectional data (n = 6,487) from four Nordic countries, Denmark, Finland, Iceland and Sweden, were utilized to determine the prevalence of daily pain and its association with disability in institutional long-term care. Every resident in each of the participating institutions was assessed with Minimum Data Set version 1.0. The sample was representative of institutional long-term care in Copenhagen and Reykjavik. In addition, the data collected from Stockholm and Helsinki provided substantial information on the residents in these capitals. The results showed that 22–24 per cent of the residents experienced daily observable pain and this was most evident in the most disabled subjects. In addition to disability and female gender, diseases or conditions independently associated with pain were terminal prognosis, osteoporosis, pneumonia, arthritis, depression, anaemia, peripheral vascular disease, cancer and cardiac heart failure. The association between pain and severe cognitive impairment was negative. The results strongly indicate that daily pain in long-term care has a complex association with disability, the latter acting together with underlying diseases as a source and/or result of pain. Thus, a vicious circle between pain and disability can be anticipated.

Résumé

RÉSUMÉ

On a utilisé des données transversales (n = 6 487) de quatre pays nordiques (le Danemark, la Finlande, l'Islande et la Suède) pour établir la prévalence de la douleur quotidienne et de ses effets sur l'invalidité en milieu institutionnel de soins de longue durée. Chaque pensionnaire des établissements examinés a été évalué au moyen de la version 1.0 du Minimum Data Set. L'échantillonnage était représentatif des soins de longue durée donnés en institution à Copenhagen et Reykjavik. De plus, on a utilisé des données recueillies à Stockholm et Helsinki pour tirer des renseignements importants sur les pensionnaires de ces capitales. Les résultats indiquent qu'entre 22 et 24 pour cent des pensionnaires éprouvent des douleurs quotidiennes observables, ce qui est encore plus évident chez les sujets les plus invalides. S'ajoutant à l'invalidité et au sexe féminin, les maladies ou états associés à la douleur étaient un pronostic de maladie terminale, d'ostéoporose, de pneumonie, d'arthrite, de dépression, d'anémie, d'acrosyndrome, de cancer et de défaillance cardiaque. Le lien entre la douleur et la déficience intellectuelle grave était inexistant. Les résultats indiquent clairement que la douleur quotidienne est intimement liée à l'invalidité, celle-ci agissant sur les maladies sous-jacentes pour constituer la cause et l'effet de la douleur. On peut done voir un cercle vicieux entre la douleur et l'invalidité.

Keywords

DisabilityOlder PersonsLong-Term CareNursing HomePainInvaliditéaîné(e)ssoins de longue duréemaison de soins infirmiersdouleur
Type
Research Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 19 , supplement S2 , Fall/Automne 2000 , pp. 38 - 49
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
Copyright © Canadian Association on Gerontology 2000

Footnotes

*

In collaboration with interRAI. The authors acknowledge the support of Päivikki and Sakari Sohlberg Foundation and Finska Läkaresällskapet.

1

University of Helsinki, Haartmaninkatu 4, FIN-00290, Helsinki, Finland, (reijo.tilvis@helsinki.fi)

References

Bernabei, R., Gambassi, G., Lapane, K., Landi, F., Gatsonis, C., Dunlop, R., Lipsiz, L., Steel, K., & Mor, V. (1998). Management of pain in elderly cancer patients. Journal of the American Medical Association, 279(23), 1877–1882.CrossRefGoogle Scholar
Bernabei, R., Murphy, K., Frijters, D., DuPaquir, J-N., & Gardent, H. (1997). Variation in training programmes for Resident Assessment Instrument implementation. Age and Ageing, 26, 31–35.CrossRefGoogle ScholarPubMed
Björkgren, M.A., Häkkinen, U., Finne-Soveri, U.H., & Fries, B.E. (1999). Validity and reliability of resource utilization groups (RUG-III) in Finnish long-term care facilities. Scandinavian Journal of Public Health, 27, 228–234 CrossRefGoogle ScholarPubMed
Carpenter, G.I., Ikegami, N., Ljunggren, G., Carrillo, E., & Fries, B.E. (1997). RUG-III and resource allocation: comparing the relationship of direct care time with patient characteristics in five countries. Age and Ageing, 26 (suppl. 2), 61–65.CrossRefGoogle ScholarPubMed
Carpenter, G.I., Main, A., & Turner, G.F. (1995). Casemix for the elderly inpatient: resource utilization groups (RUGs) validation project. Age and Ageing, 24, 5–13.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., & Marx, M.S. (1993). Pain and depression in the nursing home: Corrobating results. Journal of Gerontolology, 48, 96–97.CrossRefGoogle ScholarPubMed
Farrell, M.J., Katz, B., & Helme, R.D. (1996). The impact of dementia on the pain experience. Pain, 67, 7–15.CrossRefGoogle ScholarPubMed
Ferrell, B.A. (1995). Pain evaluation and management in the nursing home. Annals of Internal Medicine, 123, 681–687.CrossRefGoogle ScholarPubMed
Ferrell, B.A., Ferrell, B.R., & Osterweil, D. (1990). Pain in the nursing home. Journal of the American Geriatrics Society, 38, 409–414.CrossRefGoogle ScholarPubMed
Ferrell, B.A., Ferrell, B.R., & Rivera, L. (1995).Pain in cognitively impaired nursing home patients . Journal of pain & Symptom Management, 10(8), 591–598.CrossRefGoogle ScholarPubMed
Fisher-Morris, M., Gellatly, A. (1997).The experience and expression of pain in Alzheimer patients. Age and Ageing, 26, 497–500.CrossRefGoogle ScholarPubMed
Fries, B. E., Schneider, D.P., Foley, W. J., Gavazzi, M., Burke, R., & Cornelius, E. (1994). A case-mix measure for nursing homes: Resource utilization groups(RUG-III). Medical Care, 32, 665–685.CrossRefGoogle Scholar
Frederiksen, K., Tariot, P., & DeJonghe, E. (1996). Minimum Data Set Plus (MDS+) scores compared with scores from five rating scales. Journal of the American Geriatrics Society, 44, 305–309.CrossRefGoogle ScholarPubMed
Gagliese, L., & Melzack, R. (1997). Chronic pain in the elderly people. Pain, 70, 3–14.CrossRefGoogle ScholarPubMed
Gardner, M.J., & Altman, D.G. (Eds.), (1989). Statistics with confidence intervals and statistic guidelines. British Medical Journal, 50–63.Google Scholar
Guccione, A.A., Meenan, R.F., & Anderson, J.J.(1989). Arthritis in nursing home residents. Arthritis and rheumatism, 32(12), 1546–1553.CrossRefGoogle ScholarPubMed
Hartmaier, S.L., Sloane, P.D., Guess, H.A., & Koch, G.G. (1994). The MDS cognition scale: A valid instrument for identifying and staging nursing home patients with dementia using Minimum Data Set. Journal of the American Geriatrics Society, 42, 1173–1179.CrossRefGoogle Scholar
Ikegami, N., Fries, B.E., Takagi, Y., Ikeda, S., & Ibe, T., (1994). Applying RUG-III in Japanese long-term facilities. Gerontologist, 34, 628–639.CrossRefGoogle Scholar
Morris, J.N., Hawes, C., Fries, B.E., Phillips, C.D., Mor, V., Katz, S., Murphy, K., Drugovich, M.L., & Friedlob, A.S. (1990). Designing the national, resident assessment instrument for nursing homes. Gerontologist, 30, 293–307.CrossRefGoogle ScholarPubMed
Morris, J.N., Hawes, C., Murphy, K., Nonemaker, S., Phillips, C.D., Fries, B.E., & Mor, V., (1991). Resident assessment instrument training manual and resource guide. Natick, MA: Eliot Press.Google Scholar
Morris, J.N., Fries, B.E., Mehr, D.R., Hawes, C., Phillips, C., Mor, V., & Lipsitz, L.A. (1994). MDS Cognitive Performance Scale. Journal of Gerontology. Medical Sciences, 43(4), M174–M182.CrossRefGoogle Scholar
Parker, M.G., Brattberg, G., & Thorslund, M. (1998). A population study of pain among the oldest old: The importance of cognitive ability and proxy responses. XIV Nordic congress of gerontology. Abstract book, p. 90.Google Scholar
Parmelee, P.A. (1996). Pain in cognitively impaired persons. Clinics in Geriatric Medicine, 12, 473–487.CrossRefGoogle Scholar
Parmelee, P.A., Katz, I.R., & Lawton, M.P. (1991). The relation of pain to depression among institutionalized aged. Journal of Gerontolology, 46, 15–21.CrossRefGoogle ScholarPubMed
Parmelee, P.A., Smith, B., & Katz, I.R., (1993). Pain complaints and cognitive status among elderly institution residents. Journal of the American Geriatrics Society, 41, 517–522.CrossRefGoogle ScholarPubMed
Porter, F.L., Malthora, K.M., Wolf, C.M., Morris, J.C., Miller, J.P., & Smith, M.C. (1996). Dementia and response to pain in the elderly. Pain, 68, 413–421.CrossRefGoogle ScholarPubMed
Sengstaken, E.A., & King, S.A. (1993). Problems of pain and its detection among geriatric nursing home residents. Journal of the American Geriatrics Society, 41, 541–544.CrossRefGoogle ScholarPubMed
Sgadari, A., Morris, J.N., Fries, B.E., Ljunggren, G., Jonsson, P., DuPasquier, J-N., & Schroll, M. (1997). Efforts to establish the reliability of the Resident Assessment Instrument. Age and Ageing, 26 (suppl. 2), 27–30.CrossRefGoogle ScholarPubMed
Stein, W.M., & Ferrell, B.A., (1996). Pain in the nursing home. Clinics in Geriatric Medicine, 12, 435–459.CrossRefGoogle ScholarPubMed