Does pain matter in the Australian Royal Commission into Aged Care Quality and Safety? A text mining study

Background

Pain is often poorly documented, assessed and managed in the Australian aged care sector. The Australian Government called for the Royal Commission into Aged Care Quality and Safety (RC) to investigate the serious concerns, neglects and abuses including the inadequate pain management seen in the sector. This study examined the degree to which the RC discussed the issue of pain in their published reports and recommendations.

Methods

A text mining study with a computer-assisted term frequency analysis identified mentions of the word “pain” in the text of two key reports produced by the RC: the Interim Report and the Final Report. Main outcome measures included frequency of mentions of “pain”, cumulative percentile rank of the word “pain”, proportion of words that were “pain”, and frequency of mentions of the word “pain” in quotes.

Results

The word “pain” was mentioned often in the Interim Report (n = 10, 0.03% of all words, 87th percentile) and the Final Report (n = 218, 0.05% of all words, 97th percentile). However, the word “pain” was absent from final recommendations of the RC.

Conclusions

Although the RC discussed pain in their reports, the topic was omitted from recommendations, reflecting a lack of attention to the presented evidence. Without specific recommendations for pain management, a disconnection may arise between targeted polices, programs and funding schemes, and the clinical practice. Thus, older adults living in the community and residential aged care homes may remain vulnerable.