Measuring pain intensity in nursing home residents.
Assessing pain intensity in nursing home residents remains a challenge. As part of a multifaceted intervention study to improve pain practices in nursing homes, quarterly pain assessments were conducted in 12 Colorado nursing homes. Residents who reported pain or discomfort of any kind in the past 24 hours were asked to choose one of three pain intensity scales to quantify their current and highest level of pain intensity. They were also observed for pain behaviors using Feldt's Checklist of Nonverbal Pain Indicators. Residents preferred the Verbal Descriptor Scale almost 2:1 over the 11-point Verbal Numeric Rating Scale and the Faces Pain Scale. Sex and ethnicity were associated with differences in scale preference. More than one-half of residents reporting pain had an observable pain indicator. There was a monotonic relationship between reported pain intensity and number of observed pain indicators. To improve pain assessment and management in nursing homes, residents should be given a choice of pain intensity scales and observed for possible pain behaviors.
Jones
Katherine R
KR
Yale University School of Nursing, New Haven, Connecticut 06536, USA.
Fink
Regina
R
Hutt
Evelyn
E
Vojir
Carol
C
Pepper
Ginnette A
GA
Scott-Cawiezell
Jill
J
Mellis
B Karen
BK
D000369:Aged, 80 and over; D003120:Colorado / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D010146:Pain / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D010147:Pain Measurement / Q000379:methods* / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires