Communication About Chronic Pain in Older Persons' Social Networks: Study Protocol of a Qualitative Approach

Abstract

A lack of social relations appears to impact on health and life expectancy among the older persons. The quality and diversity of social relations are correlated with good health and well-being in later life. Chronic pain is a crucial issue in aging population. Effective communication between the older persons with chronic pain, their relatives and the actors of the healthcare system facilitates the management of this condition. Studies on communication in later life generally do not consider the older persons' social network as a whole, focusing only a specific segment (e.g., family or medical staff). This lack of scientific data prevents the actors of the healthcare system from offering solutions to bridge clinically relevant communication gaps. As a consequence, our study has three objectives: (1) to identify how the older persons perceive communication about chronic pain with their social network; (2) to identify their unmet communication needs; (3) to develop recommendations that improve communication about chronic pain in later life. The study will be divided into two phases. The first phase will meet objectives 1 and 2. It will involve individual interviews with about 50 people over 75 years old suffering from chronic pain and without major cognitive or auditory troubles. In this phase, we will apply a multi-layered analysis. We will map the older persons' personal network and identify their communication practices and needs, by combining content and discourse analysis with social network theories. The second phase of the study will aim at recommendations based on the results of the first phase (objective 3). It will require focus groups with different sets of stakeholders (older persons, relative caregivers, health professionals, decision-makers). In the second phase, we will use content analysis to pinpoint the concerns and suggestions for action. The results will be disseminated on three levels: (1) to the scientific world (specialists in the field of health and aging and health communication); (2) to health practitioners working with older persons; (3) to society at large, with a focus on institutions and groups directly concerned by the issue.

Talking about chronic pain in family settings: a glimpse of older persons’ everyday realities

“…In this study, which was carried out by a multidisciplinary research team including medicine, linguistics, and psychology, we interviewed 49 persons over 75 years of age having chronic pain in order to examine their perceptions of the nature of communication about chronic pain and to identify their communicative needs. In order to do this, we adopted a qualitative approach that combined content and discourse analysis with qualitative social network analysis [ 31 ]. The study was carried out within the Lausanne University Hospital (Switzerland), and the research team was advised by a steering committee including medical and nursing staff, experienced researchers, and decision-makers working in the field of health in older populations.…”

“…The sample was built specifically to reflect the diversity of the older population in terms of sociodemographic variables (see Table 1 ), because social affiliations and trajectories affect health communication [ 31 , 33 ]. We set a threshold of at least about 10 persons per group within a variable.…”

“…Four researchers jointly carried out the coding while receiving a continuous feedback from the other members of the research team. The coding was inductive and relied on a process of intercoder agreement [ 31 ]. The analysis identified the semantic categories that are used by the participants to report and explain how they communicate about chronic pain within their social network.…”

“…Our study [ 31 ] examined the communication of chronic pain in older persons’ social network, which combines a multiplicity of actors such as family, friends, medical staff, etc. It aimed to give a glimpse of their everyday realities, to which health practitioners have little access, and also to have a better understanding of what it is like to live with chronic pain in later life.…”

Friendship in Later Life: How Friends Are Significant Resources in Older Persons’ Communication about Chronic Pain

“…To analyse the interviews, we combined discourse and content analysis with a qualitative social network analysis [22]. A steering committee (with medical and nursing staff, experienced researchers and decision-makers working on later-life issues) accompanied the research team throughout the project.…”