The relationship of reported pain severity to perceived effect on function of nursing home residents.
BACKGROUND
We examined whether questions addressing the effect of pain on day-to-day function add unique information to the standardized verbal descriptor scale for pain severity in nursing homes (NHs).


METHODS
Interviews were conducted with 123 residents in two Veterans Affairs NHs. All participants were asked about pain presence. Residents reporting pain were asked about severity of worst pain (mild, moderate, severe, very severe/horrible), degree of bother (not at all, a little, a moderate amount, a great deal), and the effect of pain on daily function (whether pain made it hard to "sleep," "get out of bed," or "spend time with other people" and whether activities were limited because of pain).


RESULTS
Fifty-one percent of participants reported pain. The correlation between pain severity report and overall count of activity interference was significant (Spearman's rho=.449, p=.001). In general, for each activity, the proportion reporting interference increased as severity increased. Fischer's exact test showed significant association only for "hard to get out of bed" (p=.0175) and "hard to sleep" (p=.0211). As expected, residents reporting "mild" pain reported less activity interference than those reporting "very severe" pain. The association between pain and activity interference was more variable and less predictable among residents with "moderate" or "severe" pain.


CONCLUSIONS
Questions addressing the effect of pain on day-to-day functions are an important addition to standardized pain assessments, particularly for persons who report intermediate levels of pain severity because the perceived effect on daily function may vary most among individuals at these levels.
School of Nursing, University of California, Factor 5-952, Box 956919, Los Angeles, CA 90095-6919, USA. mcadogan@sonnet.ucla.edu
Mary P
MP
Cadogan
Maria Orlando
MO
Edelen
Karl A
KA
Lorenz
Malia
M
Jones
Julia
J
Yosef
Thomas
T
Hascall
Barbara
B
Simon
Judith O
JO
Harker
Bruce
B
Ferrell
Debra
D
Saliba
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D010146:Pain / Q000503:physiopathology / Q000523:psychology*; D010147:Pain Measurement; D010465:Perception; D011788:Quality of Life