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

J Palliat Care. 2017 Apr;32(2):61-68. doi: 10.1177/0825859717724686. Epub 2017 Aug 28.

Abstract

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.

Keywords: RAI-HC; disruptive pain; end-of-life; home care; older adults; seriously ill; standardized assessment.

MeSH terms

  • Activities of Daily Living / psychology*
  • Adaptation, Psychological
  • Aged
  • Aged, 80 and over
  • Chronic Pain / psychology*
  • Cross-Sectional Studies
  • Female
  • Home Care Services
  • Humans
  • Male
  • Ontario
  • Pain Measurement / methods*