Funded by the Bureau of Health Professions, U.S. Department of Health and Human Services, California Healthcare Foundation, UCLA Claude Pepper Center, and Commonwealth Fund. Some results were presented at the Presidential Poster Session, American Geriatrics Society Annual Scientific Meeting, Baltimore, Maryland, May 16, 2003
Using the Minimum Data Set to Select Nursing Home Residents for Interview About Pain
Article first published online: 18 NOV 2004
Journal of the American Geriatrics Society
Volume 52, Issue 12, pages 2057–2061, December 2004
How to Cite
Chu, L., Schnelle, J. F., Cadogan, M. P. and Simmons, S. F. (2004), Using the Minimum Data Set to Select Nursing Home Residents for Interview About Pain. Journal of the American Geriatrics Society, 52: 2057–2061. doi: 10.1111/j.1532-5415.2004.52565.x
- Issue published online: 18 NOV 2004
- Article first published online: 18 NOV 2004
- Minimum Data Set;
- pain assessment;
- cognitive impairment;
- nursing home
Objectives: To determine how many nursing home residents can provide stable responses to a simple pain interview and whether a Minimum Data Set (MDS) cognitive performance measure can be used to identify these residents.
Design: Cross-sectional descriptive study.
Setting: Thirty-three community-based nursing homes.
Participants: Eight hundred ninety-five nursing home residents.
Measurements: Resident completion rate, stability, and interrater reliability of a four-item interview derived from the Geriatric Pain Measure were calculated. Demographic data and MDS items concerning pain and memory were obtained from medical records.
Results: Overall, 835 residents were able to answer all four interview questions. At the lowest MDS recall score of 0, 52.7% of residents were able to complete all questions. All residents able to respond to the interview achieved high stability (kappa=0.633, P<.001). Overall, 62.8% of residents with daily pain or activity-limiting pain on interview did not have daily or moderate to severe pain recorded on the MDS. Residents who had lower MDS recall scores were significantly less likely (P=.004) to be appropriately identified on the MDS.
Conclusion: Residents with a low MDS recall score were significantly less likely to be noted on the MDS as having serious pain despite being able to complete a simple yes/no interview about pain in a stable fashion. Nursing staff should attempt to ask all residents direct questions about pain. Surveyors may restrict direct questioning to those residents with an MDS recall score of 1 or higher if time is an important consideration. Adjustment for MDS-derived prevalence of pain based on residents' cognitive status is questionable.