Pain and its association with disability in institutional long-term care in four Nordic countries

Cross-sectional data (n = 6,487) from four Nordic countries, Denmark, Finla nd, Iceland and Sweden, were utilized to determine the prevalence of daily pain and its association with disability in institutional long-term care. E very resident in each of the participating institutions was assessed with M inimum Data Set version 1.0. The sample was representative of institutional long-term care in Copenhagen and Reykjavik. In addition, the data collecte d from Stockholm and Helsinki provided substantial information on the resid ents in these capitals. The results showed that 22-24 per cent of the resid ents experienced daily observable pain and this was most evident in the mos t disabled subjects. In addition to disability and female gender, diseases or conditions independently associated with pain were terminal prognosis, o steoporosis, pneumonia, arthritis, depression, anaemia, peripheral vascular disease, cancer and cardiac heart failure. The association between pain an d severe cognitive impairment was negative. The results strongly indicate t hat daily pain in long-term care has a complex association with disability, the latter acting together with underlying diseases as a source and/or res ult of pain. Thus, a vicious circle between pain and disability can be anti cipated.