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Prevalence and intensity of chronic pain and self-perceived health among elderly people: a population-based study1

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      Abstract

      OBJECTIVE:

      to identify the prevalence and intensity of chronic pain among elderly people of the community and to analyze associations with the self-perceived health status.

      METHOD:

      cross-sectional study with a populational sample (n=934), conducted through household interviews in the city of Goiânia, Brazil. The intensity of chronic pain (existing for 6 months or more) was measured using a numerical scale (0-10) and the self-perceived health through a verbal scale (very good, good, fair, poor, very poor). For the statistical analysis, the absolute frequency and percentage, CI (95%), Chi-square test, Odds ratio, and regression analysis were used. Significance of 5%.

      RESULTS:

      The prevalence of chronic pain was 52.8% [CI (95%):49.4-56.1]; most frequently located in the lower limbs (34.5%) and lumbar region (29.5%); with high or the worst possible intensity for 54.6% of the elderly people. The occurrence of chronic pain was associated with (p<0.0001) a worse self-perception of health (OR=4.2:2.5-7.0), a greater number of chronic diseases (OR=1.8:1.2-2.7), joint disease (OR=3.5:2.4-5.1) and the female gender (OR=2.3:1.7-3.0). A lower intensity of chronic pain was associated with a better self-perception of health (p<0.0001).

      CONCLUSION:

      the majority of the elderly people of the community reported chronic pain, of a severe intensity, and located in areas related to movement activities, thus influencing the morbidity and mortality of this population.

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      Most cited references 56

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      "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.

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        The prevalence of pain and pain interference in a general population of older adults: cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP).

        Although pain is experienced at all ages, there is uncertainty about the pattern of its occurrence in older people. We have investigated the prevalence of three aspects of self-reported pain-occurrence of any recent pain, number and location of pain sites, and interference with daily life-to determine their association with age in older people. A cross-sectional postal survey of all adults aged 50 years and over registered with three general practices (n = 11230) in North Staffordshire using self-complete questionnaires was conducted. Respondents' gender, age, employment status, socio-economic classification, and general health status were gathered to characterise the population under study. The location of any recent pain (past 4 weeks) was recorded on a full-body manikin and pain interference was based on a single question. Completed questionnaires were received from 7878 respondents (adjusted response of 71.3%). The 4-week prevalence of any pain was 72.4%; similar across 10-year age-groups, and higher in females than males. In those with pain the median number of painful areas (from 44) was 6, and 12.5% of the responding population were classified as having widespread pain, both figures similar across age-groups. Most regional pains showed a decline in prevalence in the older age-groups, the exceptions being the lower limb regions (hip, knee, foot). Pain that interfered with daily activities was reported by 3002 (38.1%) respondents overall. There was a clear age-related rise in this prevalence with age up to and including the oldest group. Within each regional pain subgroup, the proportion of people who also reported pain interference rose with age. Our study has provided evidence that increasing age in the elderly population is not associated with any change in the overall prevalence of pain, although, as previous studies have suggested, the pattern of pain prevalence in different body regions does change with age. More importantly the extent to which pain interferes with everyday life increases incrementally with age up to the oldest age-group in the community-dwelling general population.
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          Chronic pain and poor self-rated health.

          Chronic pain is common in Western societies. Self-rated health is an important indicator of morbidity and mortality, but little is known about the relation between chronic pain and self-rated health in the general population. To analyze the association between chronic pain and self-rated health. A questionnaire survey carried out during the spring of 2002 of an age- and sex-stratified population sample of 6500 individuals in Finland aged 15 to 74 years, with a response rate of 71% (N = 4542) after exclusion of those with unobtainable data (n = 38). Chronic pain was defined as pain with a duration of at least 3 months and was graded by frequency: (1) at most once a week; (2) several times a week; and (3) daily or continuously. On the basis of a 5-item questionnaire on self-rated health, individuals were classified as having good, moderate, or poor health. Multinominal logistic regression analysis was used to assess the determinants of health. Analysis included sex, age, education, working status, chronic diseases, and mood. Perceived chronic pain graded by frequency and self-rated health status. The prevalence of any chronic pain was 35.1%; that of daily chronic pain, 14.3%. The prevalence of moderate self-rated health was 26.6% and of poor health, 7.6%. For moderate self-rated health among individuals having chronic pain at most once a week compared with individuals having no chronic pain, the adjusted odds were 1.36 (95% confidence interval [CI], 1.05-1.76); several times a week, 2.41 (95% CI, 1.94-3.00); and daily, 3.69 (95% CI, 2.97-4.59). Odds for poor self-rated health were as follows: having chronic pain at most once a week, 1.16 (95% CI, 0.65-2.07); several times a week, 2.62 (95% CI, 1.76-3.90); and daily, 11.82 (95% CI, 8.67-16.10). Chronic pain is independently related to low self-rated health in the general population.
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            Author and article information

            Affiliations
            [2 ] PhD, Adjunct Professor, Faculdade de Enfermagem, Universidade Federal de Goiás, Goiânia, GO, Brazil
            [3 ] MSc, RN
            [4 ] MSc, RN, Hospital das Clínicas, Universidade Federal de Goiás, Goiânia, GO, Brazil. RN, Secretaria Municipal de Saúde, Prefeitura de Goiânia, Goiânia, GO, Brazil
            [5 ] PhD, Adjunct Professor, Departamento de Enfermagem em Educação e Saúde Comunitária, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil
            [6 ] PhD, Associate Professor, Faculdade de Enfermagem, Universidade Federal de Goiás, Goiânia, GO, Brazil
            [7 ] PhD, Full Professor, Faculdade de Enfermagem, Universidade Federal de Goiás, Goiânia, GO, Brazil
            Author notes
            Corresponding Author: Lilian Varanda Pereira Universidade Federal de Goiás. Faculdade de Enfermagem e Nutrição Rua 227, Qd. 68, s/n Setor Leste Universitário CEP: 74605-080, Goiânia, GO, Brasil E-mail: lilianvaranda7@ 123456gmail.com
            Journal
            Rev Lat Am Enfermagem
            Rev Lat Am Enfermagem
            Revista Latino-Americana de Enfermagem
            Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
            0104-1169
            1518-8345
            Jul-Aug 2014
            : 22
            : 4
            : 662-669
            25296151 4292652 10.1590/0104-1169.3591.2465

            This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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            Figures: 1, Tables: 4, References: 25, Pages: 8
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