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Demographics, Psychological Distress, and Pain From Pressure Injury

Kim, Junglyun; Lyon, Debra; Weaver, Michael T.; Keenan, Gail; Stechmiller, Joyce

doi: 10.1097/NNR.0000000000000357

Background There is a knowledge gap regarding factors that influence the intensity of pain associated with pressure injuries.

Objectives We examined the influence of age, gender, race, and comorbidity on the relationships between pressure injuries, psychological distress, and pain intensity in hospitalized adults.

Methods This study was a cross-sectional, retrospective secondary analysis using data from a regional acute hospital’s electronic health records from 2013 to 2016. A sample of 454 cases met the inclusion criteria and were analyzed using path analysis.

Results The hypothesized model (Model A) and two alternative models (Models B and C) were tested and demonstrated adequate model fit. All tested models demonstrated statistically significant independent direct effects of age on the severity of pressure injury (p < .001) and pain intensity (p = .001), as well as independent direct effects of gender (p ≤ .005), race (p < .001), and comorbidity (p = .001) on psychological distress.

Discussion Pain management for individuals with pressure injuries should include not only the treatment of wounds but also the individual characteristics of the patient such as demographics, comorbidity, and psychological status that may affect pain. Given the limitations of secondary analyses, further studies are suggested to validate these findings.

Junglyun Kim, PhD, RN, is Post-Doctoral Associate, University of Florida College of Nursing, Gainesville.

Debra Lyon, PhD, RN, FAAN, is Professor and Executive Associate Dean/Thomas M. and Irene B. Kirbo Endowed Chair, University of Florida College of Nursing, Gainesville.

Michael T. Weaver, PhD, RN, FAAN, is Professor and Associate Dean for Research and Scholarship, University of Florida College of Nursing, Gainesville.

Gail Keenan, PhD, RN, FAAN, is Professor, Annabel Davis Jenks Endowed Professor for Teaching and Research in Clinical Nursing Excellence, and Chair, Department of Family, Community and Health System Science, University of Florida College of Nursing, Gainesville.

Joyce Stechmiller, PhD, APRN, FAAN, is Associate Professor, University of Florida College of Nursing, Gainesville.

Accepted for publication December 9, 2018.

We appreciate Dr. Xinguang Chen, PhD, MD, Professor, Department of Epidemiology, College of Public Health and Health Profession & College of Medicine, University of Florida, for advising the proposal of this publication’s research. We also thank the University of Florida Integrated Data Repository and the University of Florida Health Office of the Chief Data Officer for providing us with the necessary data sets.

This publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under University of Florida Clinical and Translational Science Award UL1TR001427. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors have no conflicts of interest to report.

Ethical Conduct of Research: Institutional review board approval was obtained from the University of Florida Institutional Review Board prior to study commencement.

Corresponding author: Junglyun Kim, PhD, RN, University of Florida College of Nursing, P.O. Box 100197, Gainesville, FL 32610-0197 (e-mail:

Online date: March 4, 2019

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