TY - JOUR
T1 - Pain-Associated Clusters Among Nursing Home Residents and Older Adults Receiving Home Care in Germany
AU - Budnick, Andrea
AU - Kuhnert, Ronny
AU - Wenzel, Arlett
AU - Tse, Mimi
AU - Schneider, Juliana
AU - Kreutz, Reinhold
AU - Dräger, Dagmar
N1 - Publisher Copyright:
© 2020 American Academy of Hospice and Palliative Medicine
PY - 2020/7
Y1 - 2020/7
N2 - Context: There are no available data regarding pain-associated clusters among nursing home residents (NHRs) and older adults receiving home care with chronic pain. Objectives: To identify and describe pain-associated clusters in NHRs and older adults receiving home care with chronic pain and to explore associations with clusters in both settings. Methods: We surveyed 137 NHRs and 205 older adults receiving home care. Clusters were identified using hierarchical agglomerative cluster analysis, using Ward's method with squared Euclidean distances in the proximities matrix. The clusters were characterized based on sociodemographic 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 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 NHRs. 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.
AB - Context: There are no available data regarding pain-associated clusters among nursing home residents (NHRs) and older adults receiving home care with chronic pain. Objectives: To identify and describe pain-associated clusters in NHRs and older adults receiving home care with chronic pain and to explore associations with clusters in both settings. Methods: We surveyed 137 NHRs and 205 older adults receiving home care. Clusters were identified using hierarchical agglomerative cluster analysis, using Ward's method with squared Euclidean distances in the proximities matrix. The clusters were characterized based on sociodemographic 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 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 NHRs. 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.
KW - Cluster
KW - chronic pain
KW - home care
KW - long-term care
KW - nursing home
UR - http://www.scopus.com/inward/record.url?scp=85082767089&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2020.01.018
DO - 10.1016/j.jpainsymman.2020.01.018
M3 - Article
C2 - 32044425
AN - SCOPUS:85082767089
SN - 0885-3924
VL - 60
SP - 48
EP - 59
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 1
ER -