The Influence of Physical and Psychosocial Factors on Disruptive Pain Among Seriously Ill Home Care Patients

• Published in: Journal of palliative care Vol. 32; no. 2; pp. 61 - 68
• Main Authors: Davidson, Jacob G. S., Guthrie, Dawn M.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-04-2017; SAGE PUBLICATIONS, INC
• Subjects: Activities of Daily Living - psychology; Adaptation, Psychological; Aged; Aged, 80 and over; Chronic Pain - psychology; Cognitive ability; Cross-Sectional Studies; Female; Home Care Services; Home health care; Humans; Illnesses; Male; Medical personnel; Medical prognosis; Older people; Ontario; Pain management; Pain Measurement - methods; Palliative care; Patients; Ontario Canada; Canada; standardized assessment; home care; older adults; end-of-life; disruptive pain; seriously ill; RAI-HC
• ISSN: 0825-8597; 2369-5293
• DOI: 10.1177/0825859717724686

Objectives:
To estimate the prevalence and correlates of disruptive pain in a sample of seriously ill home care patients in the Canadian province of Ontario.
Methods:
The design was a cross-sectional analysis of secondary data from 2757 patients aged 65+.
Results:
Overall, 69.0% (n = 1902) had any level of pain and 41.6% (n = 1146) indicated that their pain disrupted their usual activities. In the univariate analysis of demographics, the risk of disruptive pain decreased significantly with increasing age (P < .0001) and was significantly less common among men (P = .0015). Multivariate analysis showed that unsteady gait (relative risk [RR] = 1.37; 95% confidence interval [CI], 1.18-1.59), arthritis (RR = 1.35; 95% CI, 1.23-1.49), symptoms of depression (RR = 1.24; 95% CI, 1.13-1.37), and declines in social activity that the patient rated as distressing (RR = 1.19; 95% CI, 1.08-1.31) were independently associated with disruptive pain.
Conclusion:
Disruptive pain is highly prevalent in this group, and the key factors associated with this outcome represent physical as well as psychosocial domain areas.