Prevalence of pain among nursing home residents in rural New South Wales.

OBJECTIVE To measure the prevalence of pain among residents of rural and regional nursing homes in northern New South Wales and to describe the procedures used for pain management. DESIGN Cross-sectional survey using interviews and audit of medical records. SETTING AND PARTICIPANTS 917 nursing home residents in 15 nursing homes within a northern NSW area health service in 1998-1999. MAIN OUTCOME MEASURES Number of residents experiencing pain at the time of interview; sites of pain and magnitude of pain problem; diagnoses relevant to pain; analgesic prescribing patterns; non-pharmacological treatments for pain; and the extent of pain documentation in nursing records. RESULTS The prevalence of pain present at interview was 27.8% (95% CI, 21.8%-33.8%). Women reported pain more often than men (31% v 21%; chi(2)(2) = 5.38; P = 0.02), but pain was not significantly associated with age, length of stay, or diagnoses of arthritis or dementia. Common sites for pain were the limbs, joints and back; 22% of residents reporting pain had no record of analgesic medication, and 16% had had no form of pain treatment ordered. Agreement between the nursing record and the residents' pain symptoms was borderline poor/fair (kappa, 0.24). CONCLUSIONS The prevalence of pain is high among nursing home residents in rural NSW who are able to communicate their pain. Descriptive data suggest that pain management activities could be substantially improved.