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Pain and its Association with Disability in Institutional Long-Term Care in Four Nordic Countries

Published online by Cambridge University Press:  29 November 2010

U. Harriet Finne-Soveri ,
Gunnar Ljunggren ,
Marianne Schroll ,
Pálmi V. Jónsson ,
Ingibjörg Hjaltadottir ,
Kiddy El Kholy  and
Reijo S. Tilvis
U. Harriet Finne-Soveri
Affiliation:
Koskela Hospital, Helsinki, Finland
Gunnar Ljunggren
Affiliation:
RAI Unit, Karolinska Institute and Stockholm County Council, Stockholm, Sweden
Marianne Schroll
Affiliation:
Department of Geriatrics HL, Kommunehospitalet, Copenhagen, Denmark
Pálmi V. Jónsson
Affiliation:
Department of Geriatrics, University of Iceland, Reykjavik, Iceland
Ingibjörg Hjaltadottir
Affiliation:
Reykjavik Hospital, Geriatric Centre, Reykjavik, Iceland
Kiddy El Kholy
Affiliation:
Benediktehjemmet, Copenhagen, Denmark
Reijo S. Tilvis
Affiliation:
Department of Medicine, Geriatric Division, University of Helsinki, Finland
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Abstract

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Cross-sectional data (n = 6,487) from four Nordic countries, Denmark, Finland, Iceland and Sweden, were utilized to determine the prevalence of daily pain and its association with disability in institutional long-term care. Every resident in each of the participating institutions was assessed with Minimum Data Set version 1.0. The sample was representative of institutional long-term care in Copenhagen and Reykjavik. In addition, the data collected from Stockholm and Helsinki provided substantial information on the residents in these capitals. The results showed that 22–24 per cent of the residents experienced daily observable pain and this was most evident in the most disabled subjects. In addition to disability and female gender, diseases or conditions independently associated with pain were terminal prognosis, osteoporosis, pneumonia, arthritis, depression, anaemia, peripheral vascular disease, cancer and cardiac heart failure. The association between pain and severe cognitive impairment was negative. The results strongly indicate that daily pain in long-term care has a complex association with disability, the latter acting together with underlying diseases as a source and/or result of pain. Thus, a vicious circle between pain and disability can be anticipated.

Résumé

RÉSUMÉ

On a utilisé des données transversales (n = 6 487) de quatre pays nordiques (le Danemark, la Finlande, l'Islande et la Suède) pour établir la prévalence de la douleur quotidienne et de ses effets sur l'invalidité en milieu institutionnel de soins de longue durée. Chaque pensionnaire des établissements examinés a été évalué au moyen de la version 1.0 du Minimum Data Set. L'échantillonnage était représentatif des soins de longue durée donnés en institution à Copenhagen et Reykjavik. De plus, on a utilisé des données recueillies à Stockholm et Helsinki pour tirer des renseignements importants sur les pensionnaires de ces capitales. Les résultats indiquent qu'entre 22 et 24 pour cent des pensionnaires éprouvent des douleurs quotidiennes observables, ce qui est encore plus évident chez les sujets les plus invalides. S'ajoutant à l'invalidité et au sexe féminin, les maladies ou états associés à la douleur étaient un pronostic de maladie terminale, d'ostéoporose, de pneumonie, d'arthrite, de dépression, d'anémie, d'acrosyndrome, de cancer et de défaillance cardiaque. Le lien entre la douleur et la déficience intellectuelle grave était inexistant. Les résultats indiquent clairement que la douleur quotidienne est intimement liée à l'invalidité, celle-ci agissant sur les maladies sous-jacentes pour constituer la cause et l'effet de la douleur. On peut done voir un cercle vicieux entre la douleur et l'invalidité.

Keywords

DisabilityOlder PersonsLong-Term CareNursing HomePainInvaliditéaîné(e)ssoins de longue duréemaison de soins infirmiersdouleur
Type
Research Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 19 , supplement S2 , Fall/Automne 2000 , pp. 38 - 49
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
Copyright © Canadian Association on Gerontology 2000

Footnotes

*

In collaboration with interRAI. The authors acknowledge the support of Päivikki and Sakari Sohlberg Foundation and Finska Läkaresällskapet.

1

University of Helsinki, Haartmaninkatu 4, FIN-00290, Helsinki, Finland, (reijo.tilvis@helsinki.fi)

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