How is the experience of pain measured in older, community-dwelling people with osteoarthritis? A systematic review of the literature

Multisite joint pain in older Australian women is associated with poorer psychosocial health and greater medication use

Background

Musculoskeletal pain frequently occurs in more than one body region, with up to 80% of adults reporting more than one joint pain site in the last 12 months. Older people and females are known to be more susceptible to multiple joint pain sites, however the association of multisite joint pain with physical and psychosocial functions in this population are unknown.

Methods

Cross-sectional data from 579 women were analyzed. Women were asked "Which of your joints have been troublesome on most days of the past month?" Pain qualities were measured using the McGill Pain Questionnaire (Short Form) and PainDETECT, and health was assessed using the SF-36 and sociodemographic variables. Statistical analysis using generalized ordinal logistic regression included comparison of three joint pain groups: no joint pain, 1-4 sites of joint pain and ≥ 5 sites of joint pain.

Results

Two thirds of respondents had multisite pain (>1 site), and one third had ≥5 joint pain sites. Compared to women with fewer joint pain sites, women with >5 joint pain sites (multisite joint pain) had significantly poorer physical and emotional health-related quality of life, more severe pain, a higher probability of neuropathic pain, and a longer duration of pain. More than half of women in the multisite joint pain group were still employed, statistically significantly more than women with no joint pain. In the final model, pain duration, the number of medications, pain intensity (discomforting and distressing) and the physical component of health-related quality of life were significantly associated with increased number of joint pain sites.

Conclusions

Over one-third of older women in our sample had >5 painful joints in the last month. These women demonstrated significantly poorer psychosocial health, and increased medication use, than women with no or fewer sites of joint pain. Many women with multisite joint pain were still in the workforce, even when nearing retirement age. This study has important implications for future research into musculoskeletal pain, particularly in regards to womens health and wellbeing, and for clinical practice where there should be increased awareness of the implications of concurrent, multisite joint pain.

Predictors of happiness among older Korean women living alone

AIM

The level of happiness of older adults is associated with their psychosocial and physical health. Currently, little is known about the predictors of happiness among older women living alone in the community. The present study aimed to identify these predictors.

METHODS

This was a cross-sectional descriptive study of older women who were living alone and were registered with a social welfare center in an old urban area in South Korea. We designated various demographic factors along with health-related information, perceived self-esteem and depressive symptoms as independent variables predicting happiness. Descriptive statistics and multivariate analysis were carried out.

RESULTS

In total, 154 participants were recruited. They showed a moderate level of happiness. Furthermore, happiness was negatively correlated with the number of comorbidities, presence of pain and depressive symptoms, but positively correlated with self-esteem. The final model in hierarchical regression showed that depressive symptoms were powerful predictors of happiness after controlling the covariates and accounted for approximately 76.7% of the total variances.

CONCLUSIONS

The happiness of older women living alone was associated with their self-esteem and depressive symptoms. Interventions aimed at reducing depressive symptoms and improving self-esteem should be developed and applied to this population. Geriatr Gerontol Int 2019; 19: 352-356.

Qualitative insights into the experience of pain in older Australian women with arthritis

OBJECTIVE

To explore qualitative insights into the pain experience of older women with quantitatively derived pain profiles.

METHODS

The sequential mixed methods design involved applying quantitative pain profiles, derived from an earlier latent class analysis, to qualitative comments by a sample of older Australian women with arthritis. Data from a substudy of the Australian Longitudinal Study on Women's Health, mid-aged cohort, born 1946-1951, were used. Inductive content analysis was conducted to explore qualitative insights into the experience of pain.

RESULTS

The average age of women was 64.6 years (±1.4). Within each derived pain profile, themes generated from the qualitative comments of women were concordant with the profile descriptors: 'I manage my pain' for the uni-dimensional, mild pain profile (comments from 56 women); 'I live with pain every day' and 'I rely on medication regularly' for the moderate multidimensional pain profile (comments from 39 women); and 'multiple pains', 'I suffer with pain' and 'I am unable and adjust' for the severe multidimensional pain profile (comments from 31 women).

CONCLUSION

Women with different pain profiles used different language and strategies in managing their pain experience, information which can guide clinicians to provide more tailored support for self-management and care of arthritis pain.