title: Impact of pain on outcomes in long-term care residents with and without multiple sclerosis.
abstract: OBJECTIVE
  To compare long-term care (LTC) residents with and without multiple sclerosis (MS); to compare admission status of pain, physical disability, pressure ulcers, depression, and cognitive performance in LTC residents with and without MS; and to examine the impact of MS and pain on outcomes 90 and 180 days after LTC admission.
  
  
  METHODS
  Retrospective analysis of a large data set.
  
  
  METHODS
  LTC facilities in Missouri.
  
  
  METHODS
  Residents admitted to non-hospital-based LTC facilities.
  
  
  METHODS
  Minimum Data Set/Resident Assessment Instrument, Version 2.0; Activities of Daily Living Scale; Cognitive Performance Scale.
  
  
  RESULTS
  Residents with and without MS had similar pain prevalence and intensity after admission, with daily pain more frequent in residents with MS (P=.03). On admission, residents with MS had more physical disability (P<.001) and a greater prevalence of pressure ulcers (P=.004) and depression (P<.001) than residents without MS. In all LTC residents, initial pain status was associated with physical disability (P<.001), pressure ulcers (P<.001), depression (P<.001), and cognitive performance (P<.001) 90 and 180 days after admission. A diagnosis of MS was associated with physical disability (P<.001) 90 and 180 days after admission and pressure ulcer development 180 days after admission (P=.02).
  
  
  CONCLUSIONS
  Residents with MS were more physically disabled and had more frequent pain and a higher prevalence of pressure ulcers and depression on admission than residents without MS. Pain, or lack thereof, in residents with and without MS on admission may warn of problems that could occur within 6 months after admission to a LTC facility.
authors.affiliation: MU Sinclair School of Nursing, University of Missouri-Columbia, Missouri, USA. pnewlan@siue.edu
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Newland
authors.forename: Deidre D
authors.initials: DD
authors.lastname: Wipke-Tevis
authors.forename: Donna A
authors.initials: DA
authors.lastname: Williams
authors.forename: Marilyn J
authors.initials: MJ
authors.lastname: Rantz
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Petroski
mesh_terms: D003072:Cognition Disorders / Q000150:complications; D003863:Depression / Q000209:etiology; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000503:physiopathology*; D010146:Pain / Q000503:physiopathology*; D003668:Pressure Ulcer / Q000209:etiology; D012189:Retrospective Studies