The Association of Nursing Home Residents' Preference-Based Recreational Activity Attendance With Pain Symptoms and Functional Impairment Over Time

Background and Objectives Little work has explored how pragmatic data (i.e., usual care delivery data) can be used as an indicator of preference-based care delivery in nursing homes (NH) and how we can link these data to health of NH residents. The Preference Match Tracker (PMT) uses electronic medical records (EMRs) data to track the number of recreation activities NH residents attend weekly that match their important preferences. We explored how PMT data were linked to NH residents' reports of pain and functional impairment over time.Research Design and Methods Preferences were assessed with the Preferences for Everyday Living Inventory (PELI-NH) and MDS 3.0 and used to tabulate weekly PMT data for 586 residents from January 2016 to March 2020. Health indicators of pain/no pain (dichotomous) and functional impairment (continuous) were extracted from MDS 3.0 clinical assessments in the EMR. We employed repeated measures logistic regression and mixed linear modeling approaches, with covariates, to examine the association of attendance/refusing to attend preferred and nonpreferred activities over 1-year with pain and function.Results Pain symptoms decreased over time; functional impairment remained relatively stable. After accounting for covariates, attendance in recreational activities (preferred and nonpreferred activities) was associated with less pain and less functional impairment over time. Interestingly, refusing to attend activities (both preferred and nonpreferred) was also associated with less reported pain.Discussion and Implications There is an association of activity attendance with pain and functional ability. Tracking recreational activity attendance may help staff to support NH residents' health and well-being.