Managing pain in older persons who receive home‐help for their daily living. Perceptions by older persons and care providers

Abstract

Pain is a common problem for older persons who need professional help for their daily living. In this study 94 older persons (75+) in persistent pain were compared with 52 care providers concerning the pain management methods they had used/administered during the previous week and how helpful they perceived these methods to be. Interviews were based on 16 items from the original version of the pain management inventory (PMI). Both groups perceived prescribed medication, rest and distraction as the most frequently utilized methods. Specific methods such as transcutaneous electrical nerve stimulation (TENS) or bracing/splinting or bandaging the affected body part were seldom employed, although most users perceived these methods as helpful. Care providers perceived most methods for managing pain as more effective than older persons did. The results imply that care providers need skills in a variety of pharmacological and nonpharmacological methods to manage pain and a need to evaluate effectiveness of the methods in a systematic way.

Use of the Chronic Pain Coping Inventory to Assess Older Adults’ Pain Coping Strategies

“…As with previous studies, our results suggest that relaxation is not used frequently in this age group. 7 Finally, our participants used a variety of strategies to manage pain, a finding that is similar to that reported by others. 4,7,17,38 Two pain coping strategies not assessed by the CPCI but previously reported to be used frequently by older adults are application of heat and cold 3,38 and distraction.…”

“…Our study participants used rest on an average of 3.4 days during the past week; rest has also been found to be one of the strategies most frequently used by older adults to manage pain. 6,7,17,38 Pacing was 1 of the 2 most commonly endorsed strategies (mean, 4.2 days), consistent with a previous qualitative study 38 that found that older adults believe in the benefits of activity but also in the need not to overdo activity. As with previous studies, our results suggest that relaxation is not used frequently in this age group.…”

“…For example, the frequent use of strategies on the Task Persistence scale is consistent with previous findings 38 that many older adults try to ignore their pain and not let pain interfere with activities. Older adults often report exercise as one of the primary pain management strategies 3,4,7,38 ; exercise was used on an average of 2.7 of the previous 7 days in our study. Our study participants used rest on an average of 3.4 days during the past week; rest has also been found to be one of the strategies most frequently used by older adults to manage pain.…”

“…Many previous studies used exploratory, qualitative designs and did not administer valid, reliable pain coping measures. 3,4,7,28,38 Among studies that did include a valid coping measure, many 13,24,33,41,51 used only the Coping Strategies Questionnaire (CSQ). 37 This measure assesses only 1 behavioral pain coping strategy (in addition to 6 cognitive coping strategies) and has frequently been analyzed by using composite measures derived by factor analysis.…”

Striking a professional balance: interactions between nurses and their older rural patients

“…Research has highlighted the value of distraction and humour in improving psychological well-being (Blomqvist and Hallberg, 2002) and in managing chronic pain (Houston et al, 1998). Acute and severe pain can make a patient withdrawn and uninterested in general conversation, whereas chronic, unrelenting pain is 'lived with' and techniques for dealing with this type of pain, including humour, conversation, distraction activities and meditation were all mentioned by the older adults in this study as means of dealing with their situation.…”