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Collins JT, Irvine L, Logan P, Robinson K, Sims E, Gordon AL. Quality of life, pain and use of analgesic, anxiolytic and antidepressant medication, in people living in care homes. Age Ageing 2024; 53:afae196. [PMID: 39238123 PMCID: PMC11377180 DOI: 10.1093/ageing/afae196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/10/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND People living in care homes often have problems with pain, anxiety and depression. Whether being on analgesia, anxiolytics or antidepressants has any bearing on pain severity and quality of life (QoL) in this population, requires further investigation. OBJECTIVES (i) to examine the relationship between pain, anxiety and depression and medication use in care home residents and (ii) to compare those on medications to treat pain, anxiety and depression, and those who were not, and associations with pain severity and overall QoL. METHODS This was a secondary analysis of a randomised controlled trial testing a falls prevention intervention in care homes. We recorded pain, anxiety and depression, QoL measurements and prescribed medication use. RESULTS In 1589 participants, the mean age was 84.7 years (±9.3 SD), 32.2% were male and 67.3% had a diagnosis of dementia. 54.3% and 53.2% of participants had some level of pain and anxiety or depression respectively, regardless of prescribed medication use. There was a direct association between pain severity and being on any analgesia, opioid analgesia, and antidepressants, but no associations between pain severity and use of paracetamol and anxiolytics. QoL was best for residents with no pain and not on any analgesia, anxiolytics or antidepressants and worst for those with moderate-extreme pain and taking at least two of these classes of medications. CONCLUSION Many care home residents live with pain, anxiety and depression. Addressing residents' pain may also increase their quality of life, but using medication alone to reach this goal may be inadequate.
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Affiliation(s)
- Jemima T Collins
- Centre for Rehabilitation and Ageing, Injury, Recovery and Inflammation Sciences Academic Unit, School of Medicine, the University of Nottingham, Nottingham, UK
- University Hospitals Derby and Burton NHS Trust, Derby, UK
| | - Lisa Irvine
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | - Pip Logan
- Centre for Rehabilitation and Ageing, Injury, Recovery and Inflammation Sciences Academic Unit, School of Medicine, the University of Nottingham, Nottingham, UK
| | - Katie Robinson
- Centre for Rehabilitation and Ageing, Injury, Recovery and Inflammation Sciences Academic Unit, School of Medicine, the University of Nottingham, Nottingham, UK
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Erika Sims
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Adam L Gordon
- Centre for Rehabilitation and Ageing, Injury, Recovery and Inflammation Sciences Academic Unit, School of Medicine, the University of Nottingham, Nottingham, UK
- University Hospitals Derby and Burton NHS Trust, Derby, UK
- Applied Research Collaboration-East Midlands (ARC-EM), Nottingham, UK
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Feng PC, Khan MA, Yeh TT, Shieh WY, Tsai HH. Physiological Biomarkers for Assessment of Pain during Routine Blood Tests for Older Adults with Dementia in Long-Term Residential Care. J Am Med Dir Assoc 2024; 25:105050. [PMID: 38830593 DOI: 10.1016/j.jamda.2024.105050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVE Evaluating pain in individuals with dementia can be difficult when verbal communication is limited. Vocalization has emerged as a potential avenue for assessments of pain in nonverbal populations. This study aimed to evaluate if physiological assessments of vocalization were correlated with observational assessments of pain during routine blood tests for persons with dementia. DESIGN A cross-sectional descriptive study. SETTING AND PARTICIPANTS Sixty older adults (aged ≥65 years old) with dementia requiring routine finger puncture and peripheral venipuncture for routine blood tests were recruited by purposive sampling from 3 long-term care facilities in Taiwan. METHODS Observational assessments were conducted with the Pain Assessment in Advanced Dementia (PAINAD) instrument; physiological biomarkers of vocalization were assessed with a noninvasive sensing device and microphone (NISDM). Assessments were conducted simultaneously in one session during situations of increasing pain levels: at rest, making a sound, finger puncture, and peripheral venipuncture. PAINAD scores were compared with signal recording measures from the NISDM. Analysis of variance and Pearson correlation coefficient assessed correlations between observational and physiological measures. RESULTS Most participants were female (63.3%); mean age was 81.27 years (SD = 9.69); Clinical Dementia Rating was 2.23 ± 0.70; and Mini-Mental State Examination was 7.07 ± 6.95. Signal recording measures using the NISDM during finger puncture and venipuncture were significantly greater compared with measures at rest and making sound, indicating higher signal levels were associated with pain. PAINAD scores were significantly correlated with physiological measures for vocalization variables of sound amplitude (r = 0.49, P < .001), shimmer (r = 0.63, P < .001), and inhalation-to-exhalation amplitude ratio (r = 0.48, P < .001). CONCLUSIONS AND IMPLICATIONS Elevated vocalizations detected with the NISDM were correlated with increased pain scores on the PAINAD instrument. Physiological measures of pain using novel vocalization biomarkers have the potential to enhance the quality of care for individuals with dementia and limited communication abilities.
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Affiliation(s)
- Po-Chung Feng
- Master Degree Program in Health and Long-term Care Industry, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Mohammad Anwar Khan
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Ting-Ting Yeh
- Master Degree Program in Health and Long-term Care Industry, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Wann-Yun Shieh
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Hsin Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
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Chejor P, Atee M, Cain P, Whiting D, Morris T, Porock D. Pain prevalence, intensity, and association with neuropsychiatric symptoms of dementia in immigrant and non-immigrant aged care residents in Australia. Sci Rep 2024; 14:16948. [PMID: 39043912 PMCID: PMC11266499 DOI: 10.1038/s41598-024-68110-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 07/19/2024] [Indexed: 07/25/2024] Open
Abstract
Pain recognition for culturally diverse people is complex as pain experience is subjective and influenced by cultural background. We compared the prevalence, intensity, and association of pain with neuropsychiatric symptoms (NPS) between immigrants and non-immigrants living with dementia in residential aged care homes (RACHs) who were referred to two Dementia Support Australia programs. Immigrant status was defined by the documented country of birth. Pain and NPS were assessed using PainChek® and the Neuropsychiatric Inventory, respectively. Subgroup analyses were also completed for English-speaking and non-English-speaking immigrants. A total of 17,637 referrals [immigrants, n = 6340; non-immigrants, n = 11,297] from 2792 RACHs were included. There were no significant differences for the prevalence of pain across all groups. Immigrants were slightly more likely to have moderate pain or severe pain than non-immigrants. Non-English-speaking immigrants had 0.5 points higher total pain scores on average (Cohen's d = 0.10 [0.05, 0.15], p < 0.001) than non-immigrants. Total pain score had a significant effect on total NPS severity scores in all groups. While pain prevalence is similar across groups, higher pain intensities are more common among immigrants living with dementia. Increased care staff awareness, education, and training about the potential effect of culture on pain expression is needed.
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Affiliation(s)
- Pelden Chejor
- Centre for Research in Aged Care, School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia.
| | - Mustafa Atee
- Centre for Research in Aged Care, School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
- The Dementia Centre, HammondCare, Osborne Park, WA, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Patricia Cain
- Centre for Research in Aged Care, School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
| | - Daniel Whiting
- The Dementia Centre, HammondCare, St Leonards, NSW, Australia
| | - Thomas Morris
- The Dementia Centre, HammondCare, St Leonards, NSW, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Davina Porock
- Centre for Research in Aged Care, School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
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Booker SQ, Robinson-Lane S, Moss K, Epps F, Taylor J. Missing at Random or Not?: Evidence on Pain in Black Older Adults With Dementia and Their Caregivers. Res Gerontol Nurs 2024; 17:162-164. [PMID: 39047227 DOI: 10.3928/19404921-20240628-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Affiliation(s)
- Staja Q Booker
- University of Florida, College of Nursing, Gainesville, Florida
| | | | - Karen Moss
- The Ohio State University, College of Nursing, Columbus, Ohio
| | - Fayron Epps
- UT Health San Antonio, School of Nursing, San Antonio, Texas
| | - Janiece Taylor
- Johns Hopkins University, School of Nursing, Baltimore, Maryland
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Nakanishi M, Perry M, Bejjani R, Yamaguchi S, Usami S, van der Steen JT. Longitudinal associations between subjective cognitive impairment, pain and depressive symptoms in home-dwelling older adults: Modelling within-person effects. Int J Geriatr Psychiatry 2024; 39:e6103. [PMID: 38761159 DOI: 10.1002/gps.6103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/03/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVES Cognitive impairment, pain and depressive symptoms are common and interrelated factors in older adults. However, the directionality and specificity of their association remains unclarified. This study explored whether these factors prospectively increase reciprocal risk and examined the longitudinal association between these factors and quality of life (QoL). METHODS This study used longitudinal data from The Older Persons and Informal Caregivers Survey Minimal Data Set (TOPICS-MDS; the Netherlands). Older adults self-reported cognitive impairment, pain, depressive symptoms and QoL at baseline and after 6 and 12 months of follow-up. The Random Intercept Cross-Lagged Panel Model was used to assess the prospective association between the three factors, while a multilevel linear regression analysis in a two-level random intercept model was used to examine the longitudinal associations between the three factors and QoL at the within-person level. RESULTS The data of 11,582 home-dwelling older adults with or without subjective cognitive impairment were analysed. At the within-person level, pain at 6 months was associated with subsequent depressive symptoms (β = 0.04, p = 0.024). The reverse association from depression to pain, and longitudinal associations between pain and subjective cognitive impairment and between depressive symptoms and subjective cognitive impairment were non-significant. Pain, depressive symptoms and subjective cognitive impairment showed a significant association with poor QoL 6 months later. CONCLUSIONS A directional relationship was observed from pain to depressive symptoms. Pain reduction holds a potential benefit in the prevention of depressive symptoms, ultimately optimising the QoL of older adults.
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Affiliation(s)
- Miharu Nakanishi
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Sendai-shi, Miyagi, Japan
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Marieke Perry
- Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, the Netherlands
- Department of Geriatric Medicine, Radboud university medical center, Nijmegen, the Netherlands
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, the Netherlands
| | - Rachele Bejjani
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Satoshi Yamaguchi
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Satoshi Usami
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Jenny T van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, the Netherlands
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, the Netherlands
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van de Beek SH, Erdal A, Husebø BS, Vislapuu M, Achterberg WP, Caljouw MAA. Impact of Pain and Neuropsychiatric Symptoms on Activities in Nursing Home Residents (COSMOS Trial). J Am Med Dir Assoc 2024; 25:847-852.e3. [PMID: 38403273 DOI: 10.1016/j.jamda.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/20/2023] [Accepted: 01/10/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE This study aims to identify whether pain and dementia-related behavior are associated with different types of activities in nursing home residents, controlled for dementia severity. DESIGN Cross-sectional baseline data from the multicomponent cluster randomized controlled COSMOS trial (acronym for Communication, Systematic pain treatment, Medication review, Organization of activities, and Safety). SETTING AND PARTICIPANTS A total of 723 patients from 33 Norwegian nursing homes with 67 units (clusters). Participants aged ≥65 years, with a life expectancy of >6 months, and with valid data on activity were eligible for inclusion. METHODS Activity was operationalized in time (hours per week) and type (cognitive, social, physical, and no activity). Cognitive function was assessed using the Mini-Mental State Examination (MMSE), pain with the Mobilization-Observation-Behavior-Intensity-Dementia-2 Pain Scale (MOBID-2), and behavior with the Neuropsychiatric Inventory Nursing Home version (NPI-NH). Analyses were performed using linear and logistic regression. Sensitivity analyses for dementia severity were performed to account for effect modification. RESULTS A total of 289 participants were included (mean age 86.2 [SD 7.6]; 74% female). A higher pain score was associated with less time spent on activity in participants with severe dementia (estimate 0.897, P = .043). A higher score for the NPI-NH mood cluster (depression and anxiety) was associated with a higher likelihood of participation in cognitive activities (odds ratio [OR], 1.073; P = .039). Apathy (OR, 0.884; P = .041) and lack of inhibition (OR, 0.904; P = .042) were associated with a lower likelihood of participation in social activities as well as no engagement in activities (apathy OR, 0.880; P = .042; lack of inhibition OR, 0.894; P = .034). CONCLUSION AND IMPLICATIONS Pain and dementia-related behavior may influence the participation in activities in the nursing home. There is an urgent need to investigate what type of activity stimulates people in different stages of dementia.
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Affiliation(s)
- Sifra H van de Beek
- Department of Internal Medicine, Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands; Department of Ethics and Law, Leiden University Medical Center, Leiden, the Netherlands; Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
| | - Ane Erdal
- Department of Global Public Health and Primary Care, Center for Elderly and Nursing Home Medicine (SEFAS), Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Bettina S Husebø
- Department of Global Public Health and Primary Care, Center for Elderly and Nursing Home Medicine (SEFAS), Faculty of Medicine, University of Bergen, Bergen, Norway; Neuro-SysMed, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Maarja Vislapuu
- Department of Global Public Health and Primary Care, Center for Elderly and Nursing Home Medicine (SEFAS), Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands; University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands
| | - Monique A A Caljouw
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands; University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands
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Hassan E, Hicks B, Tabet T, Farina N. Factors associated with dementia attitudes in an adolescent cohort: Structural Equation Modelling. COGENT PSYCHOLOGY 2023; 10:23311908.2023.2235125. [PMID: 38304300 PMCID: PMC7615582 DOI: 10.1080/23311908.2023.2235125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/06/2023] [Indexed: 02/03/2024] Open
Abstract
Objective Dementia-related stigma is a key barrier to people living well with dementia, leading to social isolation and poor well-being. Adolescents represent an under-researched group that will become future carers and healthcare workers for the estimated 83.2 million people who will be living with dementia by 2030. Understanding the factors involved in dementia attitude formation in adolescents is useful for the development of evidence-based anti-stigma initiatives. This study aims to identify predictors of dementia attitudes in adolescents. Methods This is a cross-sectional study using secondary data analysis. 470 participants aged 12-15 years old from secondary schools in the Southeast of England, United Kingdom completed validated questionnaires relating to dementia attitudes (KIDS and Brief A-ADS) as well as demographic information. Multiple regressions were employed as well as a path analysis via a structural equation model to test for direct and mediatory effects. Results Multiple regression models revealed that being female, having higher levels of contact with dementia, and higher levels of empathy are positively associated with dementia attitudes in adolescents (p<0.05). Within the accepted structural equation model, empathy was a key mediator between contact and dementia attitudes. Conclusion This study highlights the pivotal role that contact with dementia can have in influencing dementia attitudes in adolescents with empathy serving as a mediator between contact and dementia attitudes. Interventions that use contact should consider how to stimulate empathetic responses to ultimately shape dementia attitudes.
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Polden M, Hanna K, Ward K, Ahmed F, Brown H, Holland C, Barrow H, Main J, Mann S, Pendrill S, Giebel C. Do community-based singing interventions have an impact on people living with dementia and their carers? A mixed-methods study protocol. BMJ Open 2023; 13:e076168. [PMID: 37996231 PMCID: PMC10668143 DOI: 10.1136/bmjopen-2023-076168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/24/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION Psychosocial interventions have been shown to improve mood, relieve stress and improve quality of life for people living with dementia (PwD). To date, most evaluations of singing interventions have focused on the benefits for PwD and not their carers. This research aims to evaluate the benefits of dementia singing groups for both PwD and their carers. METHODS AND ANALYSIS This 2-year project will observe the impact of two different singing intervention services, one combining singing alongside dance and another that includes a sociable lunch. This project will aim to recruit a total of n=150 PwD and n=150 carers across the two singing interventions. Using a mixed-methods approach, the influence of both services will be analysed via the following outcome measures: quality of life, neuropsychiatric symptoms, social isolation, loneliness, cognition, carer burden and depressive symptoms in PwD and their carers using a prestudy/poststudy design. Regression models will be used to analyse the data with time (pre/post) as the exposure variable. Semistructured interviews will be conducted with a subset of people (n=40) to further investigate the impact of singing services with a specific focus on the acceptability of the interventions, barriers to access and prolonged engagement and potential for remote delivery. Interview data will be analysed using Braun and Clarke's reflexive thematic analysis, and public advisers will assist with coding the transcripts. A social return on investment analysis will be conducted to determine the social impact of the services. ETHICS AND DISSEMINATION This project has received ethical approval from the University of Liverpool's Ethics Committee (App ref: 12374) and Lancaster University's Ethics Committee (App ref: 3442). All participants will provide informed consent to participate. Results will be presented at national and international conferences, published in scientific journals and publicly disseminated to key stakeholders.
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Affiliation(s)
- Megan Polden
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- Division of Health Research, Lancaster University, Lancaster, UK
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Kerry Hanna
- School of Health Sciences, University of Liverpool, Liverpool, UK
| | - Kym Ward
- The Brain Charity, Liverpool, Liverpool, UK
| | - Faraz Ahmed
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Heather Brown
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Carol Holland
- Division of Health Research, Lancaster University, Lancaster, UK
- Lyrics and Lunch Charity, Lancaster, UK
| | - Hazel Barrow
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | | | - Stella Mann
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | | | - Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
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Resnick B, Van Haitsma K, Kolanowski A, Galik E, Boltz M, Ellis J, Behrens L, Eshraghi K, Renn CL, Dorsey SG. Invariance of the PAINAD Scale Between the Black and White Residents Living With Dementia. FRONTIERS IN PAIN RESEARCH 2022; 2:757654. [PMID: 35295523 PMCID: PMC8915686 DOI: 10.3389/fpain.2021.757654] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/01/2021] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to test the reliability and validity of the Pain Assessment in Advanced Dementia (PAINAD) and particularly consider whether or not this measure was invariant when used among the Black and White residents. Baseline data from an implementation study testing that included a sample of 553 residents, 30% of who were Black, from 55 nursing were included in this study. The Winsteps statistical program was used to perform the Rasch analysis and evaluate the reliability and validity of the measure based on internal consistency, infit and outfit statistics, mapping, and a differential item functioning (DIF) analysis. The AMOS statistical program was used for confirmatory factor analysis. The findings supported the reliability and validity of the PAINAD when used with these individuals and demonstrated that there was no evidence of invariance between the Black and White residents. All the items fit the model, but there was not a good spread of the items across the pain level of the participants. The majority of the participants (75%) were so low in pain signs or symptoms that they could not be differentiated. Based on the clinical practice and observations, it is recommended that additional items can be added to the measure such as observing the individual for evidence of resisting care, retropulsion when trying to stand, hitting or kicking when turning in bed, hitting or kicking when transferring from bed to chair, hitting or kicking when ambulating, or hitting or kicking when raising arms, less engagement with others, and decreased participation in the activities previously enjoyed.
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Affiliation(s)
- Barbara Resnick
- Pain & Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States
| | | | - Ann Kolanowski
- Pennsylvania State University, University Park, PA, United States
| | - Elizabeth Galik
- Pain & Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States
| | - Marie Boltz
- Pennsylvania State University, University Park, PA, United States
| | - Jeanette Ellis
- Pain & Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States
| | - Liza Behrens
- Pennsylvania State University, University Park, PA, United States
| | - Karen Eshraghi
- Pennsylvania State University, University Park, PA, United States
| | - Cynthia L Renn
- Pain & Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States
| | - Susan G Dorsey
- Pain & Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States
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Quinlan-Colwell A, Schreier A. Pain Management during the COVID-19 Pandemic. Pain Manag Nurs 2022; 23:1-2. [PMID: 35093236 PMCID: PMC8790054 DOI: 10.1016/j.pmn.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/19/2021] [Indexed: 11/29/2022]
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