Is satisfaction with pain management a valid and reliable quality indicator for use in nursing homes?
OBJECTIVE
To determine whether satisfaction with pain management can be measured reliably in nursing homes and to gather preliminary data about the validity of satisfaction assessments in this population.


METHODS
Cross-sectional interview study.


METHODS
Two urban nursing homes.


METHODS
Sixty-six nursing home residents with pain.


METHODS
Overall satisfaction with pain management, satisfaction with pain medication, experiences related to pain management, cognitive function, depressive symptoms, and retest reliability of overall satisfaction rating.


RESULTS
Most residents (60/66; 91%) could rate their overall satisfaction with pain management. Overall satisfaction was weakly correlated with pain severity at the time of the interview (Spearman correlation coefficient = -0.28; P =.033) and over the past week (-0.27; P =.038). Overall satisfaction was also negatively associated with the Geriatric Depression Scale score (-0.50; P <.001). Satisfaction with pain medication was associated with several ratings of the medication's beneficial effects, including improved activity, sleep, and speed of relief, but not with the frequency with which it caused side effects. Ratings of overall satisfaction showed good reliability overall (kappa = 0.62; P <.001) and for those with Mini-Mental State Examination scores greater than 21 (kappa = 0.70; P <.001) and 21 or less (kappa = 0.54; P =.004).


CONCLUSIONS
These results suggest that satisfaction with pain management can be measured reliably when residents are able to report their pain, but further research is needed before satisfaction with pain management can be incorporated into routine assessments in nursing homes.
Casarett
David J
DJ
Philadelphia VA Medical Center, Pennsylvania, USA. casarett@mail.med.upenn.edu
Hirschman
Karen B
KB
Miller
Elizabeth R
ER
Farrar
John T
JT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology; D003430:Cross-Sectional Studies; D003863:Depression; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D059408:Pain Management; D017060:Patient Satisfaction