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

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

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

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