Horgas Ann L, Elliott Amanda F, Marsiske Michael
Department of Adult and Elderly Nursing, University of Florida, College of Nursing, Gainesville, 32610, USA.
J Am Geriatr Soc. 2009 Jan;57(1):126-32. doi: 10.1111/j.1532-5415.2008.02071.x. Epub 2008 Nov 18.
To investigate the relationship between self-report and behavioral indicators of pain in cognitively impaired and intact older adults.
Quasi-experimental, correlational study of older adults.
Data were collected from residents of nursing homes, assisted living, and retirement apartments in north-central Florida.
One hundred twenty-six adults, mean age 83; 64 cognitively intact, 62 cognitively impaired.
Pain interviews (pain presence, intensity, locations, duration), pain behavior measure, Mini-Mental State Examination, analgesic medications, and demographic characteristics. Participants completed an activity-based protocol to induce pain.
Eighty-six percent self-reported regular pain. Controlling for analgesics, cognitively impaired participants reported less pain than cognitively intact participants after movement but not at rest. Behavioral pain indicators did not differ between cognitively intact and impaired participants. Total number of pain behaviors was significantly related to self-reported pain intensity (beta=0.40, P=.000) in cognitively intact elderly people.
Cognitively impaired elderly people self-report less pain than cognitively intact elderly people, independent of analgesics, but only when assessed after movement. Behavioral pain indicators do not differ between the groups. The relationship between self-report and pain behaviors supports the validity of behavioral assessments in this population. These findings support the use of multidimensional pain assessment in persons with dementia.
研究认知功能受损和未受损的老年人疼痛的自我报告与行为指标之间的关系。
对老年人进行的准实验性相关性研究。
数据收集于佛罗里达州中北部养老院、辅助生活机构和退休公寓的居民。
126名成年人，平均年龄83岁；64名认知功能未受损，62名认知功能受损。
疼痛访谈（疼痛的存在、强度、部位、持续时间）、疼痛行为测量、简易精神状态检查表、止痛药物及人口统计学特征。参与者完成一项基于活动的方案以诱发疼痛。
86%的人自我报告有经常性疼痛。在控制了止痛药物后，认知功能受损的参与者在运动后报告的疼痛比认知功能未受损的参与者少，但休息时并非如此。认知功能未受损和受损的参与者之间的行为疼痛指标没有差异。在认知功能未受损的老年人中，疼痛行为的总数与自我报告的疼痛强度显著相关（β=0.40，P=0.000）。
认知功能受损的老年人自我报告的疼痛比认知功能未受损的老年人少，与止痛药物无关，但仅在运动后评估时如此。两组之间的行为疼痛指标没有差异。自我报告与疼痛行为之间的关系支持了该人群中行为评估的有效性。这些发现支持对痴呆症患者使用多维疼痛评估。
