“I feel so stupid because I can’t give a proper answer…” How older adults describe chronic pain: a qualitative study

Abstract

BackgroundOver 50% of older adults experience chronic pain. Poorly managed pain threatens independent functioning, limits social activities and detrimentally affects emotional wellbeing. Yet, chronic pain is not fully understood from older adults’ perspectives; subsequently, pain management in later life is not necessarily based on their priorities or needs. This paper reports a qualitative exploration of older adults’ accounts of living with chronic pain, focusing on how they describe pain, with a view to informing approaches to its assessment.MethodsCognitively intact men and women aged over sixty-five who lived in the community opted into the study through responding to advertisements in the media and via contacts with groups and organisations in North-East Scotland. Interviews were transcribed and thematically analysed using a framework approach.ResultsQualitative individual interviews and one group interview were undertaken with 23 older adults. Following analysis, the following main themes emerged: diversity in conceptualising pain using a simple numerical score; personalising the meaning of pain by way of stories, similes and metaphors; and, contextualising pain in relation to its impact on activities.ConclusionsThe importance of attending to individuals’ stories as a meaningful way of describing pain for older adults is highlighted, suggesting that a narrative approach, as recommended and researched in other areas of medicine, may usefully be applied in pain assessment for older adults. Along with the judicious use of numerical tools, this requires innovative methods to elicit verbal accounts, such as using similes and metaphors to help older adults describe and discuss their experience, and contextualising the effects of pain on activities that are important to them.

“I Try and Smile, I Try and Be Cheery, I Try Not to Be Pushy. I Try to Say ‘I'm Here for Help’ but I Leave Feeling… Worried”: A Qualitative Study of Perceptions of Interactions with Health Professionals by Community-Based Older Adults with Chronic Pain

“…However, participants did not always feel that they were listened to or heard: physicians sometimes were perceived to have unhelpfully controlled pain communication by interrupting participants' reports of pain. This is in contrast to participants' desire for the opportunity to tell their story in sufficient detail and their antipathy towards being asked to give abbreviated descriptions of their pain and its effects [22]. Indeed, participating in our research presented some with the first opportunity to talk at length about their pain, as others have found [5], [6], [15].…”

“…The findings on describing pain and its assessment are reported elsewhere [22]. This paper focuses on the interactions with health professionals.…”

Qualitative meta‐synthesis: the experience of chronic pain across conditions

“…Clarke et al . () surveyed older people with chronic pain to identify their perceptions of interactions with health professionals and found that many said that medical professionals treated them based on assumptions rather than the participants’ experiences and knowledge of their bodies. There is some evidence that these perceptions may be an accurate assessment of health care in primary care: Lalonde et al .…”

Do Gender-Specific and High-Resolution Three Dimensional Body Charts Facilitate the Communication of Pain for Women? A Quantitative and Qualitative Study

“…Expressing pain can be very difficult and verbal language is often insufficient to capture the full pain experience [19,20]. Women with chronic pain communicate the nature of their pain experience with more emphasis on the affective dimension of pain [17,21,22] where men focus on the sensory dimension [22].…”