Dräger D, Kreutz R, Wenzel A, Schneider J, Budnick A
Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Virchowweg 22, 10117, Berlin, Deutschland.
Institut für Klinische Pharmakologie und Toxikologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
Schmerz. 2021 Oct;35(5):322-332. doi: 10.1007/s00482-021-00538-5. Epub 2021 Feb 12.
Pain prevalence rates of up to 53% are found among older home-care recipients (aged ≥ 60 years). Of people affected by pain in Germany, care recipients comprise a relevant group with prevalence rates of around 70%. The available information on gender-specific pain experience shows a range of differing findings.
Our objective was to determine pain parameters of older care receivers in the big city environment who are capable of self-reporting, taking into account gender differences and relevant aspects of medical care and medication.
A cross-sectional study (structured interviews) was carried out among older (≥65 years) home-care recipients (German Social Security Code SGB XI) in Berlin, with chronic pain (n = 225), capable of self-reporting (MMST ≥ 18). Pain parameters were determined using the German version of the brief pain inventory (BPI-NHR). Multiple regression analysis was applied to test and explain how the severest pain was influenced by sociodemographic and medical parameters, mental and physical restrictions, and analgesic provision.
Analyses showed an average pain intensity of 5.3 (SD ± 2.0). The severest pain averaged 7.0 (SD ± 2.2). Few indications of significant gender-based differences were found (e.g. pain location, number of medications). The final model identified the number of pain locations (≥14), everyday abilities, and pain medication (as needed, none) as being associated with the severest pain. Treatment achieved pain relief of over 70% in only 24.6% of cases among pain-affected care receivers.
The findings indicate a significant level of pain experienced by older home-care recipients. Interdisciplinary care concepts are urgently needed.
在老年居家护理接受者（年龄≥60岁）中，疼痛患病率高达53%。在德国受疼痛影响的人群中，护理接受者是一个相关群体，患病率约为70%。关于性别特异性疼痛体验的现有信息显示出一系列不同的结果。
我们的目的是确定在大城市环境中能够自我报告的老年护理接受者的疼痛参数，同时考虑性别差异以及医疗护理和药物治疗的相关方面。
对柏林年龄≥65岁的居家护理接受者（德国社会保险法典第十一卷）进行了一项横断面研究（结构化访谈），这些接受者患有慢性疼痛（n = 225），能够自我报告（简易精神状态检查表得分≥18）。使用德文版简明疼痛问卷（BPI-NHR）确定疼痛参数。应用多元回归分析来测试和解释最严重疼痛是如何受到社会人口统计学和医学参数、心理和身体限制以及镇痛药物供应的影响。
分析显示平均疼痛强度为5.3（标准差±2.0）。最严重疼痛的平均值为7.0（标准差±2.2）。几乎没有发现明显的性别差异迹象（例如疼痛部位、药物数量）。最终模型确定疼痛部位数量（≥14个）、日常活动能力以及疼痛药物使用情况（按需使用、未使用）与最严重疼痛相关。在受疼痛影响的护理接受者中，只有24.6%的病例通过治疗实现了超过70%的疼痛缓解。
研究结果表明老年居家护理接受者经历了显著程度的疼痛。迫切需要跨学科护理理念。
