Vf. Engle et al., Accuracy and bias of licensed practical nurse and nursing assistant ratings of nursing home residents' pain, J GERONT A, 56(7), 2001, pp. M405-M411
Citations number
37
Categorie Soggetti
Public Health & Health Care Science","Medical Research General Topics
Journal title
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
Background. This study evaluated the accuracy of licensed practical nurses
(LPN) and nursing assistants' (NA) Minimum Data set (MDS) pain ratings of n
ursing home residents and evaluated the bias in pain ratings associated wit
h residents` race, gender. mental status, function, depression. or disrupti
ve behavior.
Methods, Data were obtained on the same day directly from residents. LPNs.
and NAs by trained interviewers in two safety-net nursing homes. A total of
252 residents were included in this study: 79% were Black, and 60% were me
n. MDS items J2a and J2b evaluated pain frequency and pain intensity during
the last 7 days (weekly pain frequency and weekly pain intensity). A paral
lel question evaluated pain intensity on the day of the interview (daily pa
in intensity). MDS data were obtained for the MDS Cognition Scale, the MDS
Activities of Daily Living-Long Form Scale, the MDS Depression Rating Scale
. and the MDS Disruptive Behavior Scale.
Results, Kappa coefficients documented fair to good resident-LPN (K =.70,.5
6, and .50) and resident-NA (K =.72. .58, and .60) agreement For weekly pai
n frequency, weekly pain intensity, and daily pain intensity ratings. LPNs
and NAs underestimated residents` weekly pain frequency (p < .001 fur LPNs,
and p < .001 for NAs), weekly pain intensity (p < .001 For LPNs, and p < .
001 for NAs). and daily pain intensity (p < .001 For LPNs. and p =.002 for
NAs). LPNs underestimated weekly and daily pain intensity more than NAs did
(p =.016 For weekly pain intensity. and p =.035 for daily pain intensity).
LPN and NA pain ratings were nor biased by resident race, gender. mental s
tatus, Function, depression, or disruptive behavior.
Conclusions. Results documented that (i) LPNs and NAs underestimated reside
nts' pain frequency and pain intensity. (ii) NAs were more accurate than LP
Ns for pain intensity. and (iii) resident characteristics did not bias LPN
or NA pain ratings.