Pain and self-injury ideation in elderly men and women receiving home care
Open accessAbstract
OBJECTIVES: To investigate the associations between self‐injury ideation and pain severity, pain control, and their combination in older adults receiving home care and to examine sex differences in the associations. DESIGN: Secondary data analysis, mixed‐model repeated‐measures design. SETTING: Two publicly funded home care programs in Michigan. PARTICIPANTS: Elderly participants of home care programs (N=16,700). MEASUREMENTS: All participants received in‐home assessments at baseline and every 3 months thereafter using a standardized instrument that included questions about self‐injury ideation and pain experience. Assessment data collected over 1 year after baseline were used. RESULTS: Participants' average age was 77.5; 72.2% were female, and 81.4% were white. At baseline, 1.4% of the sample (2.1% of men and 1.2% of women) had self‐injury ideation. The risk of self‐injury ideation in men increased with pain severity (some pain: adjusted odds ratio (AOR)=1.88, 95% confidence interval (CI)=1.12–3.13; severe pain: AOR=2.36, 95% CI=1.29–4.30) and pain control (controlled by medication: AOR=1.81, 95% CI=1.08–3.04; uncontrolled by medication: AOR=3.39, 95% CI=1.45–7.95). Men with severe and uncontrolled pain were at especially high risk (AOR=4.10, 95% CI=1.37–12.28). No measures of pain were significantly associated with self‐injury ideation in women. Sex differences in the association between pain severity and self‐injury ideation were significant at P <.05. CONCLUSION: Pain in older adults receiving home care should be taken seriously and treated as one means to reduce risk of suicide. Pain assessment should include severity and control of pain. In men, complaints about pain should prompt questioning about self‐injury ideation.
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Li and Conwell found that men with severe and uncontrolled pain were at especially high risk for self injury ideation, whereas no such association was observed in women.
“Li and Conwell found that men with severe and uncontrolled pain were at especially high risk for self injury ideation, whereas no such association was observed in women (31).”
From Suicide in older adults (2011) · cites this paper as [31]
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- Authors
- Li, L. W., & Conwell, Y.
- Affiliations
- University of Michigan (US)
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2010-11
- Volume
- 58
- Issue
- 11
- Pages
- 2160-2165
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC3058671
- OpenAlex
- W1512680038
- Cited by
- 27
- References
- 22
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 3 · 2018: 3 · 2015: 5 · 2014: 5 · 2013: 2 · 2012: 1
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- National Institute on Aging (AG‐024824, P30AG024824)
- National Institute of Mental Health (MH071604, R24MH071604)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD041028)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- pain intensity, pain management, older adults, home care, sex differences, suicide risk, pain assessment, older men
- MeSH terms
- Aged, Female, Home Care Services, Humans, Male, Pain, Severity of Illness Index, Self-Injurious Behavior, Suicidal Ideation
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