title: Pain reports by older adults in long-term care: a pilot study of changes over time.
abstract: OBJECTIVE
  To document self-reported pain descriptions throughout residency in a long-term care facility for a convenience sample of older adults (Canadian war veterans).
  
  
  METHODS
  The present study was a longitudinal, fixed-cohort study with anticipated attrition. Participants (n = 33) were assessed every three months from admission until attrition or end of study (three years). The assessments included standardized measures of psychosocial functioning and a comprehensive pain questionnaire for residents who reported a pain problem.
  
  
  RESULTS
  On average, respondents completed five assessments before attrition and reported pain in 69% of assessments. The likelihood of pain report decreased as the number of assessments increased. Cross-sectional analysis indicated that, at admission, pain duration was greater and nonverbal pain expression less prominent than later in residency. Longitudinal analysis indicated greater than 50% within-subject variability across three consecutive pain reports for nonpharmacological pain relief, pain expression and functional impact of pain.
  
  
  CONCLUSIONS
  The present study highlights the need for patient-centred, longitudinal investigations of both the natural progression of pain and environmental factors that mediate pain management in the interests of improving pain control for this population.
authors.affiliation: Veterans Care Program, Parkwood Hospital, St Joseph's Health Care London, London, Ontario, Canada. Maggie.gibson@sjhc.london.on.ca
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Gibson
authors.forename: M Gail
authors.initials: MG
authors.lastname: Woodbury
authors.forename: Kim
authors.initials: K
authors.lastname: Hay
authors.forename: Nancy
authors.initials: N
authors.lastname: Bol
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D001007:Anxiety / Q000523:psychology; D002170:Canada; D002908:Chronic Disease; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000523:psychology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008137:Longitudinal Studies; D009483:Neuropsychological Tests; D010146:Pain / Q000453:epidemiology* / Q000523:psychology; D010147:Pain Measurement; D010865:Pilot Projects; D011788:Quality of Life; D012189:Retrospective Studies; D014728:Veterans