title: Current state of pain care for hospitalized patients at end of life.
abstract: We report findings on the current state of pain care in hospitals for end-of-life (EOL) patients using longitudinal data from 8 diverse medical-surgical units located in 4 different Midwestern hospitals over 24 months. We identified 1425 EOL care episodes, 596 (41.3%) of which had a pain diagnosis. The percentage of EOL patients with pain varied significantly across units (P < .001) and was even lower (27.7%) for those with "acute confusion." Additionally, 30% of EOL patients had severe or significant pain at death or discharge to hospice and only 42.7% actually met the expected pain-related outcome ratings. Pain often improved within 48 hours of admission (P < .005), the improvement, however, stagnated following this initial time period (P = .92). A sizable gap between pain science and clinical practice continues.
authors.affiliation: Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL 60612-7350, USA.
authors.forename: Yingwei
authors.initials: Y
authors.lastname: Yao
authors.forename: Gail
authors.initials: G
authors.lastname: Keenan
authors.forename: Fadi
authors.initials: F
authors.lastname: Al-Masalha
authors.forename: Karen Dunn
authors.initials: KD
authors.lastname: Lopez
authors.forename: Ashfaq
authors.initials: A
authors.lastname: Khokar
authors.forename: Andrew
authors.initials: A
authors.lastname: Johnson
authors.forename: Rashid
authors.initials: R
authors.lastname: Ansari
authors.forename: Diana J
authors.initials: DJ
authors.lastname: Wilkie
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015146:Midwestern United States / Q000453:epidemiology; D010043:Outcome and Process Assessment, Health Care; D010146:Pain / Q000453:epidemiology; D059408:Pain Management / Q000451:nursing / Q000706:statistics & numerical data*; D013727:Terminal Care / Q000706:statistics & numerical data*