Pain and its treatment in older nursing home hospice/palliative care residents.
Pain and its treatment in older nursing home hospice/palliative care residents.
复制标题
老年疗养院临终关怀/姑息治疗居民的疼痛及其治疗。
DOI：
10.1016/j.jamda.2009.11.014
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发表时间：
2010
影响因子：
7.6
通讯作者：
Jaffe,EmilyJ
中科院分区：
文献类型：
--
作者：
Hanlon,JosephT;Perera,Subashan;Sevick,MaryAnn;Rodriguez,KeriL;Jaffe,EmilyJ
本研究的目的是确定疼痛的患病率，描述其治疗，并确定与分配到临终关怀专科病床或接受美国疗养院临终关怀/姑息治疗/临终特别计划服务的老年居民的任何疼痛相关的因素。对2004年全国护理之家调查数据的部分研究。设置设置为1174个美国护理之家。参与者参与者为303名65岁或以上的抽样患者，代表33，413人接受临终关怀/姑息治疗。MEASUREMENTS设施的工作人员被问及，如果在过去的7天，居民报告或显示疼痛的证据。药物使用数据来源于给药记录。有关人口统计学和健康状况的信息来自最小数据集记录。只有11.4%的居民的主要诊断是乳腺癌。总体而言，36.6%的人在前一周有任何疼痛。在有任何疼痛的患者中，86.4%接受了一些止痛药;具体而言，65.5%接受了阿片类药物，而31.7%接受了对乙酰氨基酚。与没有疼痛的人相比，有任何疼痛的人在临终关怀/姑息治疗中的停留时间较短（平均123天对161天，P <0.01），更容易出现肠失禁（60.3%对76.2%，P < .01）和膀胱（71.8%对84.5%，P=0.01）。结论：超过三分之一的老年疗养院临终关怀患者存在西班牙症状。姑息治疗的居民，尽管在三分之二的人谁报告或显示任何疼痛的证据使用阿片类药物。需要进一步的研究来改善在美国疗养院接受临终关怀/姑息治疗的老年居民的疼痛管理。
OBJECTIVESThe objectives of this study were to determine the prevalence of pain, describe its treatment, and determine factors associated with any pain in older residents assigned to a hospice specialty unit bed or receiving services from a hospice/palliative care/end-of-life special program in US nursing homes.DESIGNCross-sectional study of data from the 2004 National Nursing Home Survey.SETTINGThe setting was 1174 US nursing homes.PARTICIPANTSParticipants were 303 sampled patients, 65 years or older, representing 33,413 individuals receiving hospice/palliative care.MEASUREMENTSFacility staff was asked if, in the past 7 days, the resident had reported or shown evidence of pain. Medication use data were derived from medication administration records. Information about demographics and health status was derived from Minimum Data Set records.RESULTSCancer was the primary diagnosis in only 11.4% of residents. Overall 36.6% had any pain in the previous week. Among those with any pain, 86.4% received some analgesic; specifically, 65.5% received opioids, whereas 31.7% received acetaminophen. Those with any pain compared with those without pain had shorter lengths of stay in hospice/palliative care (mean 123 days versus 161 days, P < .01), and were more likely to be incontinent of bowel (60.3% versus 76.2%, P < .01) and bladder (71.8% versus 84.5%, P=0.01).CONCLUSIONSPain symptoms were present in more than one third of older nursing home hospice/palliative care residents despite the use of opioids in two thirds of those who had reported or shown evidence of any pain. Additional future studies are needed to improve the management of pain in older residents receiving hospice/palliative care in US nursing homes.