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Pain-Associated Clusters Among Nursing Home Residents

机译:护理家庭居民之间的痛苦相关的群集

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Abstract Chronic pain is common in older adults, particularly among nursing home residents (NHR). Internationally, the reported pain prevalence among NHR ranges from 3.7% to 79.5%. At least one in two German NHR are diagnosed with pain. Unrelieved chronic pain is associated with reduced physical functioning and psychological parameters. Given the high prevalence of pain among NHR, we hypothesized that there were likely pain-associated clusters in our target group. Clustering is an opportunity to identify differences in pain management and may enable better targeted health-service delivery for professionals. There are no available data regarding pain-associated clusters (sub-groups of NHR) based on different items measuring pain. This study was performed using baseline data, and was part of a cluster-randomized controlled trial conducted in 12 nursing homes in Berlin. We assessed pain using the German Brief Pain Inventory (BPI-NHR) among 137 NHR (mean age, 83.33 years) capable of self-report. We performed hierarchical agglomerative cluster analysis to generate three clusters (naming is based on the mean value of each BPI-NHR item in each cluster): pain-relieved (46.72 %), pain-restricted (22.63 %), and severe pain (30.66 %). Body-Mass-Index (F(2,129) = 4.274, P = 0.016), Barthel-Index (F(2,133) = 3.246, P = 0.042), and appropriateness of pain medication (F(2,119) = 12.007, P = 0.000) differed between clusters. Parameters associated with an increased or decreased risk of being in a pain-diagnosed cluster will be discussed. The observed need for clinical interventions aiming at shifting from pain-diagnosed clusters to pain-relieved status will be reflected.
机译:摘要慢性疼痛在老年人中是常见的,特别是在护理家庭居民(NHR)中。国际上,NHR之间报道的疼痛患病率从3.7%到79.5%。两种德国NHR中的至少一个被诊断为疼痛。不缓解的慢性疼痛与减少的物理功能和心理参数有关。鉴于NHR中疼痛的患病率很高,我们假设我们的目标群体中可能存在痛苦相关的群集。聚类是识别痛苦管理差异的机会,并可以为专业人士提供更好的针对性的健康服务。基于测量疼痛的不同物品,没有有关疼痛相关簇(NHR子组)的可用数据。本研究使用基线数据进行,是在柏林12名护理家庭中进行的集群随机对照试验的一部分。我们在能够自我报告的137个NHR(平均年龄,8333年)中使用德国简短的疼痛库存(BPI-NHR)评估了疼痛。我们进行了分层凝聚的聚类分析以产生三种簇(命名基于每个簇中的每个BPI-NHR项的平均值):缓解缓解(46.72%),疼痛限制(22.63%)和严重的疼痛(30.66 %)。体重指数(F(2,129)= 4.274,P = 0.016),Barthel-Index(F(2,133)= 3.246,P = 0.042),止痛药的适当性(F(2,119)= 12.007,P = 0.000 )簇之间的不同。将讨论与增加或减少存在于疼痛诊断群集群中的参数。观察到需要针对疼痛诊断簇转移到疼痛缓解状态的临床干预的需求将被反映。

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