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J Pain Symptom Manage. 2020 Feb 7. pii: S0885-3924(20)30070-1. doi: 10.1016/j.jpainsymman.2020.01.018. [Epub ahead of print]

Pain-Associated Clusters Among Nursing Home Residents and Older Adults Receiving Home Care in Germany.

Author information

1
Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany. Electronic address: andrea.budnick@charite.de.
2
Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany.
3
School of Nursing, Hong Kong Polytechnic University, Hong Kong, China.
4
Institute of Clinical Pharmacology and Toxicology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Abstract

CONTEXT:

There are no available data regarding pain-associated clusters among nursing home residents and older adults receiving home care with chronic pain.

OBJECTIVES:

To identify and describe pain-associated clusters in nursing home residents and older adults receiving home care with chronic pain, and to explore associations with clusters in both settings.

METHODS:

We surveyed 137 nursing home residents and 205 older adults receiving home care. Clusters were identified using hierarchical agglomerative cluster analysis, utilizing Ward's method with Squared Euclidean Distances in the proximities matrix. The clusters were characterized based on socio-demographic and clinical characteristics. Multinomial logistic regression was used to identify variables associated with different clusters.

RESULTS:

In each setting, we identified three clusters: pain-relieved, pain-impaired, and suffering severe pain. In the nursing home study and the home care study, respectively, the participant distributions were 46.72% and 11.71% in the pain-relieved cluster, 22.63% and 33.66% in the pain-impaired cluster, and 30.66% and 54.63% in the severe-pain cluster. Appropriate pain medication was only detected among pain-relieved nursing home residents.

CONCLUSION:

Overall, differences in pain management exist within the two care settings presented here. There is potential for improvement in both settings. Moreover, there exists a need for clinical interventions aiming at shifting from pain-affected clusters to pain-relieved status.

KEYWORDS:

Cluster; chronic pain; home care; long-term care; nursing home

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