Abstract
BackgroundIn the past decade, the number of long-term care (LTC) services for older adults in China has grown annually by an average of 10%. Older adults, their family members, and policymakers in China are concerned about patient outcomes in different care settings because older adults who have a similar functional status and LTC needs may choose either nursing home care or home care. The aim of this study was to compare pain perception in nursing home care and home care settings for physically dependent older adults in China.MethodsMulti-stage sampling method was used to recruit respondents aged 65 and older from Yichang City, China, in 2015. The researchers employed a two-step analytical strategy—zero-inflated ordered probit regression followed by propensity score matching method—to model the effect of contrasting residence types on pain perception.ResultsZero-inflated ordered probit regression analysis with participants unmatched (n = 484) showed that compared with older adults who received home care, those who received nursing home care did not have more severe pain (β = 0.088, SE = 0.196, p = 0.655). After propensity-score matching, the research found that older adults in the home care group perceived less pain compared with the nursing home group (β = 0.489, SE = 0.169, p = 0.004).ConclusionsThe older adults who received home care perceived significantly less pain than the nursing home residents. The pain of older adults may differ based on the type of LTC services and therapy intensity they received, and home care might lead to less pain and better comfort than nursing home care.
Highlights
IntroductionThe number of long-term care (LTC) services for older adults in China has grown annually by an average of 10%
55.6% of the sample was composed of nursing home residents and 45.4% were community-dwelling older adults
Using the interRAI local survey data from Yichang City, China, this study investigated whether living in nursing home or at home would pain perception of older adults
Summary
The number of long-term care (LTC) services for older adults in China has grown annually by an average of 10%. Evidence indicates that pain has a stronger association with health outcomes, such as depression, anxiety, social isolation, sleep disorders, malnutrition, loss of appetite, cognitive disorders, and delirium [1, 3, 5, 14, 15]. With their high physical vulnerability, pain substantially decreases older people’s activities of daily living (ADLs) and reduces quality of life, which in turn leads to higher health care cost [9, 16, 17]. Improving pain management, in long-term care system, should be regarded as a priority for healthcare services
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