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, Finland, Iceland and Sweden, were utilized to determine the prevalence of daily pain and its association with disability in institutional long-term care. Every resident in each of the participating institutions was assessed with Minimum Data Set version 1.0. The sample was representative of institutional long-term care in Copenhagen and Reykjavik. In addition, the data collected from Stockholm and Helsinki provided substantial information on the residents in these capitals. The results showed that 22-24 per cent of the residents experienced daily observable pain and this was most evident in the most disabled subjects. In addition to disability and female gender, diseases or conditions independently associated with pain were terminal prognosis, osteoporosis, pneumonia, arthritis, depression, anaemia, peripheral vascular disease, cancer and cardiac heart failure. The association between pain and severe cognitive impairment was negative. The results strongly indicate that daily pain in long-term care has a complex association with disability, the latter acting together with underlying diseases as a source and/or result of pain. Thus, a vicious circle between pain and disability can be anticipated.