Get access

Non-verbal cues to osteoarthritic knee and/or hip pain in elders

Authors

  • Pao-Feng Tsai,

    Corresponding author
    1. Alice An-Loh Sun Endowed Professorship in Geriatric Nursing, College of Nursing, University of Arkansas for Medical Sciences, 4301 West Markham St. Slot 529, Little Rock, AR 72205
    • Alice An-Loh Sun Endowed Professorship in Geriatric Nursing, College of Nursing, University of Arkansas for Medical Sciences, 4301 West Markham St. Slot 529, Little Rock, AR 72205.
    Search for more papers by this author
    • Associate Professor.

  • Yong-Fang Kuo,

    1. Sealy Center on Aging, Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX
    Search for more papers by this author
    • Associate Professor.

  • Cornelia Beck,

    1. Department of Geriatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
    Search for more papers by this author
    • Professor.

  • Kathy Richards,

    1. University of Pennsylvania, School of Nursing, Philadelphia, PA
    Search for more papers by this author
    • Professor.

  • Kevin M. Means,

    1. Department of Physical Medicine and Rehabilitation, the University of Arkansas for Medical Sciences, Little Rock, AR
    Search for more papers by this author
    • Professor.

  • Barbara L. Pate,

    1. College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR
    Search for more papers by this author
    • Clinical Instructor.

  • Francis J. Keefe

    1. Department of Psychiatry and Behavioral Science, Duke University Medical Center, Durham, NC
    Search for more papers by this author
    • Professor.


  • This study was supported by a grant provided by the National Institute of Nursing Research (R15NR008405). It was also partially supported by the John A. Hartford Foundation, under the Building Academic Geriatric Nursing Capacity Scholar Program and the National Institute on Aging funded Alzheimer's Disease Center (P30 AG019606) and by National Institute of Arthritis and Musculoskeletal and Skin Disease grants (R01 AR054626 and P01 AR50245). The authors also thank Elizabeth Tornquist for editorial assistance. A version of the paper was presented as a poster at the American Pain Society annual conference in 2010. An abstract was published in the Journal of Pain, 11(4 Suppl.), p. S1

Abstract

Behavioral cues are believed to be useful to identify pain among elders who may be experiencing pain but unable to express it. To examine this assumption, we recruited 192 elders who could verbally express pain to determine whether regression models combining behavioral cues (motor and gait patterns) predicted verbal pain reports. In the best model, age (p < .01) and subscales that measured guarding (p < .001) and joint flexion (p < .01) motor patterns were significant predictors of verbal pain reports. The receiver operating characteristic curve indicated that the best cutoff for predictive probability was 40–44%, with a fair to good C statistic of .78 (SD = .04). With a 40% cutoff, sensitivity and specificity were 71.6% and 71.0%, respectively. The investigators concluded that the final model could serve as a building block for the development of a tool using behavioral cues to identify elders' pain. © 2011 Wiley Periodicals, Inc. Res Nurs Health 34:218–227, 2011

Get access to the full text of this article

Ancillary