Using the minimum data set to select nursing home residents for interview about pain.
OBJECTIVE
To determine how many nursing home residents can provide stable responses to a simple pain interview and whether a Minimum Data Set (MDS) cognitive performance measure can be used to identify these residents.


METHODS
Cross-sectional descriptive study.


METHODS
Thirty-three community-based nursing homes.


METHODS
Eight hundred ninety-five nursing home residents.


METHODS
Resident completion rate, stability, and interrater reliability of a four-item interview derived from the Geriatric Pain Measure were calculated. Demographic data and MDS items concerning pain and memory were obtained from medical records.


RESULTS
Overall, 835 residents were able to answer all four interview questions. At the lowest MDS recall score of 0, 52.7% of residents were able to complete all questions. All residents able to respond to the interview achieved high stability (kappa=0.633, P<.001). Overall, 62.8% of residents with daily pain or activity-limiting pain on interview did not have daily or moderate to severe pain recorded on the MDS. Residents who had lower MDS recall scores were significantly less likely (P=.004) to be appropriately identified on the MDS.


CONCLUSIONS
Residents with a low MDS recall score were significantly less likely to be noted on the MDS as having serious pain despite being able to complete a simple yes/no interview about pain in a stable fashion. Nursing staff should attempt to ask all residents direct questions about pain. Surveyors may restrict direct questioning to those residents with an MDS recall score of 1 or higher if time is an important consideration. Adjustment for MDS-derived prevalence of pain based on residents' cognitive status is questionable.
Chu
Lily
L
Department of Medicine, Division of Geriatrics, Los Angeles Jewish Home for the Aging, School of Medicine, CA, USA. ChuRainier@aol.com <ChuRainier@aol.com>
Schnelle
John F
JF
Cadogan
Mary P
MP
Simmons
Sandra F
SF
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002140:California; D003072:Cognition Disorders / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D009735:Nursing Homes; D015588:Observer Variation; D010147:Pain Measurement; D018579:Patient Selection; D015203:Reproducibility of Results