Incidence and risk factors for care-induced pain in adults with physical disability: An observational study

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain Pub Date : 2025-09-11 DOI:10.1016/j.jpain.2025.105554

Gwenaël Cornec , Victor Plantier , Arnaud Brasseur , Emmanuelle Courtois-Communier , Sylvain Brochard , Amandine Dubois

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引用次数: 0

Abstract

Care facilities for adults with physical disability provide a range of personal, medical care and rehabilitation support involving physical contact. Little is known about pain induced by these physical acts in this setting. This non interventional, observational, prospective, multicentre study aimed to measure the incidence of care-induced pain in adults with physical disability, and aimed to identify risk factors and prevention methods used. The setting was 16 randomly drawn neurological rehabilitation centres (n=5) and long-term care facilities (n=11) in 4 counties of Brittany, France. 163 adults with physical disability were randomly selected (median [IQR] age: 52 [40–62] years; sex ratio: 1.7). The main pathologies were acquired brain injury, cerebral palsy and spinal cord injury. All physical acts performed over 5 days and 1 night were recorded and pain was measured using FLACC-r. Descriptive analyses and a multivariate model predicting FLACC-r intensity were conducted. Of the 5580 acts analysed, 6% were rated as painful and 36% of the participants experienced care-induced pain at least once during the study period. Attendant care was the most frequent and frequently painful class of act. In the multivariate analysis, level of dependency, physical act class and sex predicted FLACC-r intensity (all p<0.01). Pain prevention means were not routinely used (12%). Care-induced pain is frequently experienced by adults with physical disability in neurological rehabilitation centres and long-term care facilities during any act involving direct physical contact and appears to be a lifespan issue.

Perspective

This study measured an incidence of 6% of pain during usual physical acts in adults with physical disability. Any professional involved should be aware of this risk. Routine pain assessment and prevention are keys to improve practices, therapeutic alliance and quality of life for adults with physical disability.

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身体残疾成人护理性疼痛的发生率和危险因素：一项观察性研究。

身体残疾成人护理设施提供一系列涉及身体接触的个人护理、医疗护理和康复支助。在这种情况下，人们对这些身体行为引起的疼痛知之甚少。这项非干预性、观察性、前瞻性、多中心研究旨在测量身体残疾成人护理性疼痛的发生率，并旨在确定危险因素和预防方法。选取法国布列塔尼4个县随机抽取的16家神经康复中心（n=5）和长期护理机构（n=11），随机抽取163名身体残疾成人（中位[IQR]年龄：52[40-62]岁，性别比：1.7）。主要病理为后天性脑损伤、脑瘫和脊髓损伤。记录5天1夜的所有身体行为，并使用FLACC-r测量疼痛。进行了描述性分析和预测FLACC-r强度的多变量模型。在分析的5580个行为中，6%被评为疼痛，36%的参与者在研究期间至少经历过一次由护理引起的疼痛。辅助护理是最常见和最痛苦的一类行为。在多变量分析中，依赖程度、身体行为类别和性别预测FLACC-r强度（p < 0.05）

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来源期刊

Journal of Pain 医学-临床神经学

CiteScore

6.30

自引率

7.50%

发文量

441

审稿时长

42 days

期刊介绍： The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.