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Racial and Ethnic Variation in Pain Following Inpatient Palliative Care Consultations
Author(s) -
Laguna Jeff,
Goldstein Rebecca,
Braun William,
Enguídanos Susan
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12709
Subject(s) - medicine , ethnic group , confidence interval , palliative care , intervention (counseling) , multivariate analysis , hospital discharge , physical therapy , gerontology , psychiatry , nursing , sociology , anthropology
Studies have documented high levels of pain in hospitalized individuals at the end of life, with minorities reporting higher levels of pain than whites. In response, inpatient palliative care ( IPC ) teams have grown rapidly to improve care of seriously ill individuals. Although research indicates that IPC teams effectively reduce and maintain control of pain, racial and ethnic differences in pain following IPC consultation remain unclear. This study investigated racial and ethnic pain differences after an IPC intervention in 385 seriously ill white, black, and L atino individuals aged 65 and older. Using the 11‐point N umeric R ating S cale for pain, individuals were asked to rate their pain intensity at four points during hospitalization (before IPC consultation, 2 and 24 hours after the consultation, and at hospital discharge). Results indicate that whites ( F 1.657, 173.998 = 16.528, P < .001), blacks ( F 1.800, 95.410 = 7.103, P = .002), and L atinos ( F 1.388, 73.584 = 10.902, P < .001) all experienced significant reductions in pain after the intervention. Adjusted multivariate models testing between‐group racial and ethnic differences revealed that L atinos were 62% more likely than whites to report experiencing pain at hospital discharge (relative risk = 0.38, 95% confidence interval = 0.15–0.97). Regardless of race or ethnicity, IPC effectively reduces and controls pain after consultation. Despite pain decreases, L atinos remain more likely than whites to report pain at follow‐up. Further research is needed to determine the mechanisms in operation and to better understand and address the needs of this population.