The perceptions of older adults living with chronic musculoskeletal pain about participating in an intervention based on a behavioral medicine approach to physical therapy

Abstract

Background There is evidence that interventions based on a behavioral medicine approach to physical therapy (BMPI) are beneficial for older adults living with chronic pain; however, knowledge of the perceptions of older people regarding their participation in BMPI is lacking. Aim The aim of this study was to describe the perceptions of older people about being participants in a home-based BMPI. Methods Semi-structured interviews were conducted with 12 older adults living with chronic pain and participating in a BMPI. Data were analyzed using qualitative content analysis. Results The respondents highlighted the importance of the home-based and individualized nature of the intervention. They perceived the support from the physical therapist (PT) as significant for their motivation and goal attainment. The benefits of the intervention were described in physical, psychological, social, and functional terms, and as enabling participants to live at home for longer. Conclusion The results show that participation in a BMPI was perceived as a positive and meaningful experience. Support from a PT is crucial to encouraging behavioral changes. Finally, participation in a BMPI may contribute to the ability of participants to 'age in place' for longer.

<p>Effects of a behavioral medicine intervention on pain, health, and behavior among community-dwelling older adults: a randomized controlled trial</p>

“…The results of the present study are in line with the results from a recently published qualitative study evaluating how older adults perceive to participate in a BMPI and their perceived gains. The gains of the intervention were by the informants described in physical, psychological, social, and functional terms and enabling participants to live at home for longer 51. Finally, the results support the hypothesis of the study protocol, whereby BMPI can be a suitable evidence-based intervention for community-dwelling older adults living with chronic musculoskeletal pain 15…”

A qualitative study exploring physical therapists’ views on the Otago Exercise Programme for fall prevention: a stepping stone to “age in place” and to give faith in the future

“…The present study revealed that the OEP seems to promote "age in place" in terms of improved physical function, mastering of everyday activities, improved self-efficacy, and a higher degree of independence. This finding is in line with that of a recently published study about an intervention focusing on exercise and behavior change for older adults living with chronic pain (Cederbom, Nortvedt, and Lillekroken, 2019). Promotion of "aging in place" is of high clinical relevance, as this is the main goal for all interventions that healthcare professionals conduct in their daily practice (Cederbom, 2014).…”

“…Therefore, the description that the OEP is easy to individualize and adapt to older adults' physical abilities is very encouraging, particularly given that these factors have been proven to promote adherence to exercise among this target population (Cederbom et al, 2014b;Manor and Lipsitz, 2013). Other crucial factors in the context of promoting adherence are that the intervention is performed in an environment that is suitable for the individual and that it provides available support (Arkkukangas et al, 2017;Cederbom, Nortvedt, and Lillekroken, 2019;Jiménez-Beatty Navarro et al, 2007), which the present study confirmed. Moreover, when implementing the OEP in clinical practice, the present study's findings show how important it is to carefully customize and adapt the support of PTs based on the older person's needs, such as the number of home visits and support by telephone.…”

“…Ultimately, these actions will promote and optimize the possibility of the older adult reaching the overall goal of the OEP, which in the longterm, is to remain at home longer (Cederbom, Von Heideken Wågert, Söderlund, and Söderbäck, 2014;Sjölund, 2014). Being able to perform everyday activities is also of high clinical value and relevant when engaging older people in exercise interventions (Cederbom, Nortvedt, and Lillekroken, 2019); which the present study's findings also support.…”

“…From a clinical perspective, we specifically wanted to highlight the positive benefit of improved self-efficacy because a decreased self-efficacy is a risk factor for the development of disability among community-dwelling older people (Cederbom, Von Heideken Wågert, Söderlund, and Söderbäck, 2014;Rejeski et al, 2001). It is also very encouraging that PTs considered the OEP to contribute to and enable the older adults to be more social and participate in social activities outside the home more often because social isolation can be a threat to an individual's health and quality of life (Bradbeer et al, 2003;Cederbom, Nortvedt, and Lillekroken, 2019).…”