A Minimum Data Set Prevalence of Pain Quality Indicator: Is It Accurate and Does It Reflect Differences in Care Processes?
Open Access
- 1 March 2004
- journal article
- research article
- Published by Oxford University Press (OUP) in The Journals of Gerontology: Series A
- Vol. 59 (3), M281-M285
- https://doi.org/10.1093/gerona/59.3.m281
Abstract
Background. A new prevalence of pain quality indicator based on the Minimum Data Set (MDS) has been developed for the purpose of providing nursing home (NH) consumers with information that would allow them to compare the quality of pain care between facilities. The purpose of this study was to compare pain-related care processes between NHs that scored in the lower 25th percentile (low pain prevalence) or upper 75th percentile (high pain prevalence) based on this indicator. Methods. Care processes related to pain assessment, documentation, and treatment were independently evaluated using standardized resident interview and medical record review protocols for 255 residents in 16 NHs that reported MDS pain prevalence of less than 15% (8 NHs in lower 25th percentile) or greater than 30% (8 NHs in upper 75th percentile). Results. A significantly greater proportion of participants in the high pain prevalence NHs reported symptoms indicative of chronic pain during interview. The standardized pain interview revealed a significantly higher prevalence of pain among participants in the lowest quartile NH group compared to the MDS pain prevalence quality indicator, but the pain prevalence according to both MDS and interview were comparable in the higher quartile NHs. Medical record review showed that a significantly greater proportion of participants in upper quartile NHs had pain assessments documented by licensed nurses and physicians, received pain medication, and had documentation of treatment response. Conclusions. An MDS pain quality indicator accurately discriminates prevalence of pain between facilities. However, interpretation of the pain indicator requires caution. Rather than reflecting poor quality, a high prevalence of pain according to the MDS was associated with better pain assessment and treatment care processes.Keywords
This publication has 9 references indexed in Scilit:
- The Identification of Residents Capable of Accurately Describing Daily CareThe Gerontologist, 2001
- Pain in U.S. Nursing HomesThe Gerontologist, 2001
- The Geriatric Pain Measure: Validity, Reliability and Factor AnalysisJournal of the American Geriatrics Society, 2000
- Assessing Pain in Older AdultsInternational Psychogeriatrics, 2000
- Correlates and Management of Nonmalignant Pain in the Nursing HomeJournal of the American Geriatrics Society, 1999
- Pain in cognitively impaired nursing home patientsJournal of Pain and Symptom Management, 1995
- Pain Complaints and Cognitive Status among Elderly Institution ResidentsJournal of the American Geriatrics Society, 1993
- The Problems of Pain and Its Detection among Geriatric Nursing Home ResidentsJournal of the American Geriatrics Society, 1993
- Pain Management in Elderly PeopleJournal of the American Geriatrics Society, 1991