Healthcare Worker Factors Influencing Reports of Pain Judgments about Older Patients with Cancer and Delirium

Healthcare workers (HCWs) rely on behavioural cues to judge pain in older adults with cancer and delirium. This study identified HCW factors associated with pain judgments about older patients with advanced cancer who are cognitively intact or have delirium, including the hypoactive, hyperactive, and mixed subtypes. Fifty-three HCWs with experience in pain-related specialties were interviewed on their experiences regarding pain judgments about this patient population. The Cancer Pain and Delirium Scale (CPDS) was used to score each interview transcript for reported pain cues for each patient group. Backward regression models found that age, discipline, specialty, years of experience in palliative oncology or geriatrics, percentage of older patients cared for per month, and pain catastrophizing each contributed to at least one of the models for CPDS INT, DEL, HYPO, and HYPER. These results support the biopsychosocial model of pain and aging and highlight the influence HCW factors have on pain assessments.