Does age make a difference in procedural pain perceptions and responses in hospitalized adults?

Objective: As part of a major study on procedural pain, perceptions of pain and responses to various procedures in younger and older adults were examined. Procedures included wound care, wound drain removal, tracheal suctioning, turning, femoral sheath removal and central line insertion. Pharmacological treatments of pain and procedural distress by age were also examined. Design: Prospective, descriptive-correlational. Setting: Critical and acute care units in acute care hospitals. Participants: Acute and critically ill adults undergoing a procedure (wound care, wound drain removal, tracheal suctioning, turning, femoral sheath removal and central line insertion). There were 5957 participants in the sample, 3126 younger (18-64 years) and 2831 older adults (+65 years). Methods: Pain intensity, behaviours and quality were measured prior, during and after the procedure. Results: Data showed pain intensity was greatest during the procedure, but did not differ according to age. More younger than older patients received analgesics; however, use of analgesics in both was minimal. Pain quality words and pain behaviours observed were similar in both groups. Procedural distress was mild but significantly greater in younger than older patients. Conclusion: These data show pain is greatest for both groups during the procedure. In addition, more persons in the younger group receive analgesics, although the mean dosage is not significantly different. Younger patients report greater distress during procedures than older ones, even though their pain intensity, words and behaviours are not different. Further attention needs to be given to understand these differences.