1
|
Connoy L, Solomon M, Longo R, Sud A, Katz J, Dale C, Stanley M, Webster F. Attending to Marginalization in The Chronic Pain Literature: A Scoping Review. Can J Pain 2024; 8:2335500. [PMID: 38831969 PMCID: PMC11146439 DOI: 10.1080/24740527.2024.2335500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/22/2024] [Indexed: 06/05/2024]
Abstract
Background There has been a recent and, for many within the chronic pain space, long-overdue increase in literature that focuses on equity, diversity, inclusion, and decolonization (EDI-D) to understand chronic pain among people who are historically and structurally marginalized. Aims In light of this growing attention in chronic pain research, we undertook a scoping review of studies that focus on people living with chronic pain and marginalization to map how these studies were carried out, how marginalization was conceptualized and operationalized by researchers, and identify suggestions for moving forward with marginalization and EDI-D in mind to better support people living with chronic pain. Methods We conducted this scoping review using critical analysis in a manner that aligns with dominant scoping review frameworks and recent developments made to scoping review methodology as well as reporting guidelines. Results Drawing on 67 studies, we begin with a descriptive review of the literature followed by a critical review that aims to identify fissures within the field through the following themes: (1) varying considerations of sociopolitical and socioeconomic contexts, (2) conceptual conflations between sex and gender, and (3) differing approaches to how people living with chronic pain and marginalization are described. Conclusion By identifying strengths and limitations in the research literature, we aim to highlight opportunities for researchers to contribute to a more comprehensive understanding of marginalization in chronic pain experiences.
Collapse
Affiliation(s)
- Laura Connoy
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Michelle Solomon
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Riana Longo
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Abhimanyu Sud
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Joel Katz
- Department of Psychology, Faculty of Health, York University, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Craig Dale
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Tory Trauma Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Meagan Stanley
- Western Libraries, Western University, London, Ontario, Canada
| | - Fiona Webster
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| |
Collapse
|
2
|
Palmitoylethanolamide in the Treatment of Chronic Pain: A Systematic Review and Meta-Analysis of Double-Blind Randomized Controlled Trials. Nutrients 2023; 15:nu15061350. [PMID: 36986081 PMCID: PMC10053226 DOI: 10.3390/nu15061350] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
Chronic pain is a major source of morbidity for which there are limited effective treatments. Palmitoylethanolamide (PEA), a naturally occurring fatty acid amide, has demonstrated utility in the treatment of neuropathic and inflammatory pain. Emerging reports have supported a possible role for its use in the treatment of chronic pain, although this remains controversial. We undertook a systematic review and meta-analysis to examine the efficacy of PEA as an analgesic agent for chronic pain. A systematic literature search was performed, using the databases MEDLINE and Web of Science, to identify double-blind randomized controlled trials comparing PEA to placebo or active comparators in the treatment of chronic pain. All articles were independently screened by two reviewers. The primary outcome was pain intensity scores, for which a meta-analysis was undertaken using a random effects statistical model. Secondary outcomes including quality of life, functional status, and side effects are represented in a narrative synthesis. Our literature search identified 253 unique articles, of which 11 were ultimately included in the narrative synthesis and meta-analysis. Collectively, these articles described a combined sample size of 774 patients. PEA was found to reduce pain scores relative to comparators in a pooled estimate, with a standard mean difference of 1.68 (95% CI 1.05 to 2.31, p = 0.00001). Several studies reported additional benefits of PEA for quality of life and functional status, and no major side effects were attributed to PEA in any study. The results of this systematic review and meta-analysis suggest that PEA is an effective and well-tolerated treatment for chronic pain. Further study is warranted to determine the optimal dosing and administration parameters of PEA for analgesic effects in the context of chronic pain.
Collapse
|
3
|
Petrie KA, Chen JN, Miears H, Grimes JS, Zumwalt M. Gender Differences in Seeking Health Care and Postintervention Pain Outcomes in Foot and Ankle Orthopedic Patients. WOMEN'S HEALTH REPORTS 2022; 3:500-507. [PMID: 35652003 PMCID: PMC9148655 DOI: 10.1089/whr.2021.0076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/13/2022]
Abstract
Background: Materials and Methods: Results: Conclusions:
Collapse
Affiliation(s)
- Kyla A. Petrie
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Jason N. Chen
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Hunter Miears
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Jerry Speight Grimes
- Department of Orthopedic Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Mimi Zumwalt
- Department of Orthopedic Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| |
Collapse
|
4
|
Dueñas M, Ojeda B, Salazar A, Mico JA, Failde I. A review of chronic pain impact on patients, their social environment and the health care system. J Pain Res 2016; 9:457-67. [PMID: 27418853 PMCID: PMC4935027 DOI: 10.2147/jpr.s105892] [Citation(s) in RCA: 515] [Impact Index Per Article: 64.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Chronic pain (CP) seriously affects the patient’s daily activities and quality of life, but few studies on CP have considered its effects on the patient’s social and family environment. In this work, through a review of the literature, we assessed several aspects of how CP influences the patient’s daily activities and quality of life, as well as its repercussions in the workplace, and on the family and social environment. Finally, the consequences of pain on the health care system are discussed. On the basis of the results, we concluded that in addition to the serious consequences on the patient’s life, CP has a severe detrimental effect on their social and family environment, as well as on health care services. Thus, we want to emphasize on the need to adopt a multidisciplinary approach to treatment so as to obtain more comprehensive improvements for patients in familial and social contexts. Accordingly, it would be beneficial to promote more social- and family-oriented research initiatives.
Collapse
Affiliation(s)
- María Dueñas
- Nursing Faculty "Salus Infirmorum", The Observatory of Pain, University of Cádiz, Cádiz, Spain
| | - Begoña Ojeda
- Preventive Medicine and Public Health Area, The Observatory of Pain, University of Cádiz, Cádiz, Spain
| | - Alejandro Salazar
- Preventive Medicine and Public Health Area, The Observatory of Pain, University of Cádiz, Cádiz, Spain
| | - Juan Antonio Mico
- Department of Neuroscience, Pharmacology, and Psychiatry, CIBER of Mental Health, CIBERSAM, Institute of Health Carlos III, University of Cádiz, Cádiz, Spain
| | - Inmaculada Failde
- Preventive Medicine and Public Health Area, The Observatory of Pain, University of Cádiz, Cádiz, Spain
| |
Collapse
|
5
|
Wakefield JRH, Sani F, Madhok V, Norbury M, Dugard P. The pain of low status: the relationship between subjective socio-economic status and analgesic prescriptions in a Scottish community sample. PSYCHOL HEALTH MED 2015; 21:27-37. [DOI: 10.1080/13548506.2015.1009377] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
6
|
Brooks EA, Unruh A, Lynch ME. Exploring the lived experience of adults using prescription opioids to manage chronic noncancer pain. Pain Res Manag 2015; 20:15-22. [PMID: 25562838 PMCID: PMC4325885 DOI: 10.1155/2015/314184] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Chronic noncancer pain (CNCP) and prescription opioid use is a highly complex and growing health care issue in Canada. Many quantitative research studies have investigated the effectiveness of opioids for chronic pain; however, gaps remain in the literature regarding the personal experience of using opioids and their impact on those experiencing CNCP. OBJECTIVE To explore the lived experience of adults using prescription opioids to manage CNCP, focusing on how opioid medication affected their daily lives. METHODS In-depth qualitative interviews were conducted with nine adults between 40 and 68 years of age who were using prescription opioids daily for CNCP. Interviews were audiorecorded and transcribed, and subsequently analyzed using interpretive phenomenological analysis. RESULTS Six major themes identified positive and negative aspects of opioid use associated with social, physical, emotional and psychological dimensions of pain management. These themes included the process of decision making, and physical and psychosocial consequences of using opioids including pharmacological side effects, feeling stigmatized, guilt, fears, ambivalence, self-protection and acceptance. CONCLUSION Although there were many negative aspects to using opioids daily, the positive effects outweighed the negative for most participants and most of the negative aspects were socioculturally induced rather than caused by the drug itself. The present study highlighted the complexities involved in using prescription opioids daily for management of CNCP for individuals living with pain.
Collapse
Affiliation(s)
- Erica A Brooks
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia
| | - Anita Unruh
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia
| | - Mary E Lynch
- Departments of Anesthesia and Psychiatry, Dalhousie University, Halifax, Nova Scotia
| |
Collapse
|
7
|
Lapane KL, Quilliam BJ, Benson C, Chow W, Kim MS. Impact of noncancer pain on health-related quality of life. Pain Pract 2014; 15:333-42. [PMID: 24571122 DOI: 10.1111/papr.12184] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 12/29/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND While the economic costs of pain have been documented, the impact of noncancer pain on quality of life has not been studied extensively. OBJECTIVE To estimate the influence of noncancer pain on quality of life measures. DESIGN Prospective, multicenter, observational nonrandomized patient pain registry. SETTING Outpatient settings. PARTICIPANTS Patients with acute episodes of noncancer pain requiring treatment with a prescription medication containing oxycodone immediate-release on an as-needed basis for at least 5 days (n = 629). MEASUREMENTS The modified Brief Pain Inventory and the 12-item Short Form Health Survey (SF-12) was measured at baseline when oxycodone immediate-release began and days 7, 14, 21, and 28. Repeated measures mixed models provided estimates of impact of pain on the physical component summary score (PCS) and mental health component summary score (MCS) of the SF-12. RESULTS Patterns indicating pain oscillation over the 28-day window were common (Range: 44.3% back/neck pain cohort to 61.2% postoperative cohort). After adjustment for sociodemographics, concomitant medications and gastrointestinal symptoms, worst pain in 24 hours was associated with a 13.9 point PCS reduction (adjusted PCS for pain = 10: 31.1; adjusted PCS for pain = 0: 45.0) and a 7.2 point MCS reduction (adjusted MCS for pain = 10: 44.1; adjusted MCS for pain = 0: 51.3). Similar clinically relevant differences were observed among patients with arthritis, back/neck pain, injury/trauma, postoperative pain, neuropathic pain and fibromyalgia, although statistical significance was not observed in the latter 2 groups. CONCLUSION Among outpatients with various underlying causes of pain, the negative impact of pain on physical and mental health-related quality of life is significant.
Collapse
Affiliation(s)
- Kate L Lapane
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, U.S.A
| | | | | | | | | |
Collapse
|
8
|
Deshaies K, Hernandez CA. Integration: A Phenomenon to Explore in Chronic Nonmalignant Pain (CNP). Pain Manag Nurs 2011; 12:2-14. [DOI: 10.1016/j.pmn.2009.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 10/24/2009] [Accepted: 10/26/2009] [Indexed: 10/19/2022]
|
9
|
The relationship of demographic and psychosocial variables to pain-related outcomes in a rural chronic pain population. Pain 2011; 151:467-474. [PMID: 20817401 DOI: 10.1016/j.pain.2010.08.015] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2010] [Revised: 08/04/2010] [Accepted: 08/04/2010] [Indexed: 11/23/2022]
Abstract
Rural residency and low socioeconomic status (SES) are associated with increased likelihood of chronic pain. Other demographics are also differentially associated with the experience of pain. This study examines the relations between demographic and pain-related variables in a virtually unstudied population of rural Alabama chronic pain patients. One hundred and fifteen patients completed validated measures of pain catastrophizing, depression, pain intensity, pain interference, perceived disability, and life satisfaction. Average age of study participants was 52-years, 79% were female, 74% were African-American, 72% reported annual income between 00,000-12,999, and 61% were unemployed. Although average years of reported education was 12.26, reading level percentile (primary literacy indicant) was 17.33. Cross-sectional multivariate and univariate analyses were conducted to examine associations among demographic and psychosocial variables in relation to various pre-treatment pain-related variables. The mediating role of pain catastrophizing and depression was investigated. Results indicate that race was significantly associated with pain intensity and pain interference, such that African-Americans reported higher scores than White-Americans. Pain catastrophizing was uniquely associated with pain intensity, pain interference, and perceived disability; depression was uniquely associated with pain interference and life satisfaction. Pain catastrophizing mediated the relation between primary literacy and pain intensity; age effects were differentially mediated by either pain catastrophizing or depression. These analyses provide an insight into the specific demographic and psychosocial factors associated with chronic pain in a low-literacy, low-SES rural population.
Collapse
|
10
|
The influence of psychosocial factors on quality of life among women with pain: a prospective study in Sweden. Qual Life Res 2011; 20:1215-25. [DOI: 10.1007/s11136-011-9860-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2011] [Indexed: 11/25/2022]
|
11
|
Pain and Quality of Life Among Residents of Norwegian Nursing Homes. Pain Manag Nurs 2010; 11:35-44. [DOI: 10.1016/j.pmn.2009.01.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2008] [Revised: 01/19/2009] [Accepted: 01/26/2009] [Indexed: 11/18/2022]
|
12
|
Park J, Cho B, Paek Y, Kwon H, Yoo S. Development of a pain assessment tool for the older adults in Korea: The validity and reliability of a Korean version of the geriatric pain measure (GPM-K). Arch Gerontol Geriatr 2009; 49:199-203. [DOI: 10.1016/j.archger.2008.07.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Revised: 07/23/2008] [Accepted: 07/24/2008] [Indexed: 11/30/2022]
|
13
|
Lindelof K, Ellrich J, Jensen R, Bendtsen L. Central pain processing in chronic tension-type headache. Clin Neurophysiol 2009; 120:1364-70. [DOI: 10.1016/j.clinph.2009.04.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Revised: 04/09/2009] [Accepted: 04/21/2009] [Indexed: 11/25/2022]
|
14
|
Hawke F, Burns J. Understanding the nature and mechanism of foot pain. J Foot Ankle Res 2009; 2:1. [PMID: 19144200 PMCID: PMC2631512 DOI: 10.1186/1757-1146-2-1] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Accepted: 01/14/2009] [Indexed: 12/29/2022] Open
Abstract
Approximately one-quarter of the population are affected by foot pain at any given time. It is often disabling and can impair mood, behaviour, self-care ability and overall quality of life. Currently, the nature and mechanism underlying many types of foot pain is not clearly understood. Here we comprehensively review the literature on foot pain, with specific reference to its definition, prevalence, aetiology and predictors, classification, measurement and impact. We also discuss the complexities of foot pain as a sensory, emotional and psychosocial experience in the context of clinical practice, therapeutic trials and the placebo effect. A deeper understanding of foot pain is needed to identify causal pathways, classify diagnoses, quantify severity, evaluate long term implications and better target clinical intervention.
Collapse
Affiliation(s)
- Fiona Hawke
- Podiatry Department, School of Health Sciences, Faculty of Health, University of Newcastle, NSW, Australia.
| | | |
Collapse
|
15
|
Lee GK, Chronister J, Bishop M. The Effects of Psychosocial Factors on Quality of Life Among Individuals With Chronic Pain. REHABILITATION COUNSELING BULLETIN 2008. [DOI: 10.1177/0034355207311318] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated the psychosocial factors affecting the quality of life (QOL) of 171 individuals with chronic pain. Participants completed a battery of self-rated inventories measuring three sets of predictor variables—demographic (age, gender, income, marital status), pain-specific (chronicity, severity, duration, frequency, pain impairment), and psychosocial (interference, social support, depression, coping)—and one criterion variable with five models (physical, psychological, social, environmental, total). Hierarchical multiple regression indicates that income predicts the psychological and environmental domains of QOL. Across all five models, 56% to 76% of the variance was accounted for with the three sets of variables. Demographics remained minimally predictive of all models. Pain impairment was predictive of all five models. Depression was predictive of all but physical QOL, and coping was predictive of all but physical and environmental QOL. The pain impairment variable and the two psychosocial variables (depression and coping) remained imperative in predicting QOL of individuals with chronic pain.
Collapse
|
16
|
Moliner CE, Durand MJ, Desrosiers J, Coutu MF. Subjective quality of life according to work status following interdisciplinary work rehabilitation consequent to musculoskeletal disability. JOURNAL OF OCCUPATIONAL REHABILITATION 2007; 17:667-82. [PMID: 17909950 DOI: 10.1007/s10926-007-9100-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2007] [Accepted: 08/17/2007] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Individualized subjective quality of life (ISQoL) is the appraisal of quality of life according to personal values, desired goal attainment and life priorities. "Gap" is a way to operationalize ISQoL. ISQoL is rarely measured by interdisciplinary work rehabilitation (IWR) programs attended by the musculoskeletal disorder (MSD) population. These programs commonly measure pain intensity, physical capacity, perceived disability, distress and return to work. OBJECTIVES The aims of this study were to compare ISQoL according to work status and reference values and to explore the relationships between ISQoL and common IWR measures. METHODS Six months after completing an IWR program, 40 working and 31 not-working participants completed questionnaires documenting work status, pain, ISQoL gap, health-related quality of life (SF-36, PCS and MCS), perceived disability and distress. RESULTS No significant difference in global ISQoL gap was found between working and not-working participants. When compared to reference values considerable variability exists but globally, for both groups, ISQoL gap scores were below average. The following clinical variables were related to global ISQoL (P < 0.05): pain (r = -0.42), PCS (r = -0.37), MCS (r = -0.56), perceived disability (r = 0.37) and distress (r = 0.61). High distress, present in both groups, explains 38% of the global ISQoL gap variance and PCS adds 4%. CONCLUSION Following IWR programs for the chronic MSD population, global ISQoL gap is not related to work status. The use of a client-centered interactive computerized measure of ISQoL reveals that domains related to emotional well-being are likely the most problematic for the persistently disabled MSD population.
Collapse
Affiliation(s)
- Carmen E Moliner
- Department of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | | | | |
Collapse
|
17
|
Raak R, Wahren LK. Health experiences and employment status in subjects with chronic back pain: a long-term perspective. Pain Manag Nurs 2006; 7:64-70. [PMID: 16730319 DOI: 10.1016/j.pmn.2006.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to describe health experiences, focused on gender and return to work, in subjects with chronic low back pain in a long-term perspective. The convenient sample consisted of 12 subjects who had attended a pain rehabilitation program 6 years earlier. Typed interviews were transcribed, and a content analysis approach was used. Five categories were found: coping, root causes, control/influence, pain, and sleep. The interviews showed that the subjects expressed well-being, although pain had become part of their daily life. However, both gender and well-being group differences were identified. The women and the group with reduced well-being used the root causes category in a higher degree than the men and the well-being group did. The conclusion is that there are differences according to both gender and return to work within the subjects with chronic pain and that these differences are related to both root causes and coping pattern.
Collapse
Affiliation(s)
- Ragnhild Raak
- Department of Welfare and Care, Faculty of Health Sciences, Linköpings Universitetet, SE-601 74 Norrköping, Sweden
| | | |
Collapse
|
18
|
Rustøen T, Wahl AK, Hanestad BR, Lerdal A, Paul S, Miaskowski C. Age and the experience of chronic pain: differences in health and quality of life among younger, middle-aged, and older adults. Clin J Pain 2006; 21:513-23. [PMID: 16215337 DOI: 10.1097/01.ajp.0000146217.31780.ef] [Citation(s) in RCA: 153] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To describe age differences in chronic pain and to evaluate for differences in demographic and health-related variables among younger (18-39 years), middle-aged (40-59 years), and older adults (60-81 years) who reported chronic pain. METHODS A total of 4000 Norwegian citizens were mailed a questionnaire that measured pain, quality of life, mood, and demographic and health-related variables. RESULTS Of the total sample (n = 1912), 19.2% of the younger age group, 27.5% of the middle-aged group, and 31.2% of the older group reported chronic pain (ie, >3 months duration). A total of 58.9% of the participants in chronic pain reported having a chronic disease, with the most common being musculoskeletal problems, chronic pain disorder, and osteoarthritis. Participants in the older age group reported pain of longer duration and more comorbidities and received pain treatment more often. They had higher total quality of life scores, were more satisfied with their material comforts and social life, and reported better mood. The middle-aged group reported the largest number of pain locations, reported having fibromyalgia more frequently, and reported that the cause of their pain was not known. They were less satisfied with their social life than the older age group. The younger age group reported the highest rates of injury and accidents as the cause of their pain, and almost 43% of this age group was not receiving any treatment of their chronic pain. CONCLUSION This study found that the prevalence rates for chronic pain do vary with age and that the middle-aged group may be a high-risk group of patients with chronic pain.
Collapse
Affiliation(s)
- Tone Rustøen
- Faculty of Nursing, Oslo University College, Oslo, Norway.
| | | | | | | | | | | |
Collapse
|
19
|
Chandra A, Ozturk A. Quality of life issues and assessment tools as they relate to patients with chronic nonmalignant pain. Hosp Top 2005; 83:33-7. [PMID: 16092637 DOI: 10.3200/htps.83.1.33-37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- Ashish Chandra
- Marshall University, South Charleston, West Virginia, USA
| | | |
Collapse
|
20
|
Rustøen T, Wahl AK, Hanestad BR, Lerdal A, Paul S, Miaskowski C. Gender differences in chronic pain--findings from a population-based study of Norwegian adults. Pain Manag Nurs 2004; 5:105-17. [PMID: 15359222 DOI: 10.1016/j.pmn.2004.01.004] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The purpose of this study was to evaluate for gender differences in the experience of chronic pain and the impact of chronic pain on quality of life (QOL). A total of 1,912 out of 4,000 Norwegian citizens returned a mailed questionnaire, and 24.4% reported chronic pain. More women than men reported chronic pain, and women reported significantly higher pain intensity scores than men did. Although the duration of chronic pain was similar in women and men, women more often received treatment for their chronic pain. Men in chronic pain reported a poorer QOL than women did. Although specific variables that predicted present pain intensity in women and men differed, the variables that explained the largest percentage of the variance in pain for both genders were the disease and the pain location variables. These findings support previously published studies that document gender differences in chronic pain and extend the work to the impact of chronic pain on QOL.
Collapse
Affiliation(s)
- Tone Rustøen
- Faculty of Nursing, Oslo University College, Oslo, Norway.
| | | | | | | | | | | |
Collapse
|
21
|
Widar M, Ahlström G, Ek AC. Health-related quality of life in persons with long-term pain after a stroke. J Clin Nurs 2004; 13:497-505. [PMID: 15086636 DOI: 10.1046/j.1365-2702.2003.00815.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND No study has, to our knowledge, previously been published on health-related quality of life (HRQoL) in a group suffering from long-term pain after a stroke. AIM The aim of the present study was to describe HRQoL in persons with long-term pain after a stroke, and to compare this with different types of pain conditions, age, gender and household status. DESIGN This study has a design combining qualitative and quantitative methods. METHODS Forty three participants suffering from long-term pain after a stroke were included. A qualitative interview was performed and then analysed by means of latent content analysis. In addition, two self-report questionnaires, SF-36 and the Hospital Anxiety and Depression Scale (HAD Scale), were used. RESULTS The qualitative data revealed that physical and cognitive functioning, economic security and good relationships, support and having the ability to be together with family and friends were important factors with regard to experienced HRQoL. No significant differences were found in SF-36 and the HAD Scale with regard to the different types of pain. The older age group had decreased physical functioning in SF-36. The men had more decreased vitality than the women. CONCLUSION The results show, that the participants in this study have a lower HRQoL due to their long-term pain than those in previous studies on stroke survivors. It is evident that further research is needed with longitudinal studies and larger populations to gain more knowledge and thereby provide better supportive care. RELEVANCE TO CLINICAL PRACTICE Awareness and understanding of the patients' perceptions and transitions with regard to their life situation and suffering from long-term pain after a stroke is important in order to support a maintained or increased HRQoL. This is also important after the acute stage and rehabilitation, including quality of life of the relatives, especially to older and dependent persons.
Collapse
Affiliation(s)
- Marita Widar
- Department of Medicine and Care, Division of Nursing Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
| | | | | |
Collapse
|
22
|
Abstract
Given the pervasive effect of chronic pain, a comprehensive approach to nursing care is needed. Addressing the physical effects of persistent pain on multiple systems and bodily functions requires combining (drug and nondrug) interventions to reduce pain and improve functioning. Targeting anxiety, depression and anger effectively can halt or even reverse the escalation of pain attributed to emotions. Recognizing belief patterns associated with distress and disability, while challenging patients to rethink the truthfulness of their perceptions is an important step in helping patients think, feel, and do better. Eliciting self-reflective narratives about the context of pain in their lives taps into the spiritual domain and initiates processes of grieving, forgiveness, and acceptance that are needed to transcend perceived limits and find new meaning in their lives. By attending to social interactions, including therapeutic relationships, chronic pain patients can become more independent and involved in family or socially meaningful activities. Combined, nurses can help patients restore joy, functioning, and a sense of purpose despite the devastating toll persistent pain has taken.
Collapse
Affiliation(s)
- Paul Arnstein
- William F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
| |
Collapse
|
23
|
Dickson GL, Kim JI. Reconstructing a meaning of pain: older Korean American women's experiences with the pain of osteoarthritis. QUALITATIVE HEALTH RESEARCH 2003; 13:675-688. [PMID: 12756687 DOI: 10.1177/1049732303013005006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The purpose of this grounded theory study was to gain a deeper understanding of older Korean American women's experiences of chronic osteoarthritic pain. The data included a set of 3 interviews with 7 women over age 60, field notes, observations, memos, and the literature about the chronic pain of osteoarthritis. Through constant comparative analysis and coding typical of grounded theory, a five-stage process emerged inductively from the data. The core variable, Reconstructing a Meaning of Pain, included the concepts of the process in the grounded theory through which the women learned to manage and tolerate the pain. During this process, the women came to perceive their pain as a component of aging rather than as a symptom of disease.
Collapse
|