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养老院居民样本中的慢性疼痛:患病率、特征及其对生活质量的影响

Chronic pain in a sample of nursing home residents: prevalence, characteristics, influence on quality of life (QoL).

作者信息

Zanocchi Mauro, Maero Barbara, Nicola Elena, Martinelli Elisa, Luppino Angela, Gonella Mafalda, Gariglio Federico, Fissore Laura, Bardelli Benedetta, Obialero Rossella, Molaschi Mario

机构信息

Medical and Surgical Department, Geriatric Section, University of Torino, C.so Bramante 88, I-10126 Torino, Italy.

出版信息

Arch Gerontol Geriatr. 2008 Jul-Aug;47(1):121-8. doi: 10.1016/j.archger.2007.07.003. Epub 2007 Nov 19.

Abstract

Chronic pain is common in the elderly, but it is often under-estimated and under-treated. The aim of this study was to evaluate the prevalence and characteristics of chronic pain in nursing home residents and to analyze its influence on patient's QoL and functional status. We studied 105 patients (mean age 82.2+/-9 years), living in two nursing homes in Torino, Italy. The McGill Pain Questionnaire (MGPQ), the Visual Analogical Scale (VAS) and the Face Pain Scale (FPS) were used to test pain. Depression, functional and cognitive status were also evaluated by using specific instruments, such as the Geriatric Depression Scale (GDS), Instrumental Activities of Daily Living (IADL), Activities of Daily Living (ADL) and the Mini-Mental State Examination (MMSE). Pharmacological and non-pharmacological treatments were documented. It was found that chronic pain was present in 82.9% of the sample; it lasted over 24 months and it was persistent in half of them (49.4%). We observed that chronic pain in the elderly has a strong affective component and its intensity influences older patients' mood, nutrition, sleep and QoL. Our study showed that chronic pain was under-treated. We conclude that chronic pain in institutionalized elderly is common and worsens patients' QoL. It is important to assess and manage pain as a relevant problem in particular for the population at increased risk for under-recognition and under-treatment.

摘要

慢性疼痛在老年人中很常见,但往往被低估和治疗不足。本研究的目的是评估养老院居民慢性疼痛的患病率和特征,并分析其对患者生活质量和功能状态的影响。我们对居住在意大利都灵两家养老院的105名患者(平均年龄82.2±9岁)进行了研究。使用麦吉尔疼痛问卷(MGPQ)、视觉模拟评分量表(VAS)和面部疼痛量表(FPS)来测试疼痛。还使用特定工具评估抑郁、功能和认知状态,如老年抑郁量表(GDS)、日常生活活动能力量表(IADL)、日常生活活动量表(ADL)和简易精神状态检查表(MMSE)。记录了药物和非药物治疗情况。结果发现,样本中82.9%存在慢性疼痛;疼痛持续超过24个月,其中一半(49.4%)为持续性疼痛。我们观察到老年人的慢性疼痛具有强烈的情感成分,其强度会影响老年患者的情绪、营养、睡眠和生活质量。我们的研究表明慢性疼痛治疗不足。我们得出结论,机构养老的老年人慢性疼痛很常见,会恶化患者的生活质量。评估和管理疼痛作为一个相关问题很重要,特别是对于有未被识别和治疗不足风险增加的人群。

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