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Tse MMY, Ng SSM, Lou V, Lo R, Cheung DSK, Lee P, Tang ASK. A Dyadic Pain Management Program for Community-Dwelling Older Adults with Chronic Pain: Study Protocol for a Cluster Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12186. [PMID: 36231486 PMCID: PMC9565005 DOI: 10.3390/ijerph191912186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Community-dwelling older adults suffer from chronic pain. Pain negatively affects their physical and psychosocial wellbeing. The majority of pain management education and programs focus only on older adults. Their informal caregivers should be involved in pain management. A dyadic pain management program for reducing pain and psychological health symptoms, and improving pain self-efficacy, quality of life, and physical function in older adults is proposed for evaluation of its effectiveness. This will be a cluster randomized controlled trial. Community-dwelling older adults aged 60 or above and their informal caregivers will be recruited. The dyadic pain management program will be an eight-week group-based program. The participants in the experimental group will receive four weeks of center-based, face-to-face activities and four weeks of digital-based activities via a WhatsApp group. The control group will receive the usual care and a pain management pamphlet. Data will be collected at baseline, and at the eighth-week and sixteenth-week follow-up session. The outcome measurements will include pain intensity, pain self-efficacy, perceived quality of life, depression, anxiety, and stress levels. Data on the caregiver burden will be collected from the informal caregivers. Because of the COVID-19 pandemic, all social activities have been suspended. In the near future, as the pandemic subsides, the dyadic pain management program will be launched to benefit community-dwelling older adults and informal caregivers and to reduce their pain and the care burden, respectively.
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Affiliation(s)
- Mimi M. Y. Tse
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Shamay S. M. Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Vivian Lou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Raymond Lo
- Geriatrics and Palliative Medicine, Shatin Hospital, Hong Kong, China
| | | | - Paul Lee
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Angel S. K. Tang
- School of Nursing, Caritas Medical Centre, Hospital Authority, Hong Kong, China
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ÖZER Z, BAHÇECİOĞLU TURAN G, ATAN G. Pain Management and Life Satisfaction In Elderly Individuals: A Single Centred Study. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.733524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Budnick A, Kuhnert R, Wenzel A, Tse M, Schneider J, Kreutz R, Dräger D. Pain-Associated Clusters Among Nursing Home Residents and Older Adults Receiving Home Care in Germany. J Pain Symptom Manage 2020; 60:48-59. [PMID: 32044425 DOI: 10.1016/j.jpainsymman.2020.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/24/2020] [Accepted: 01/24/2020] [Indexed: 10/25/2022]
Abstract
CONTEXT There are no available data regarding pain-associated clusters among nursing home residents (NHRs) and older adults receiving home care with chronic pain. OBJECTIVES To identify and describe pain-associated clusters in NHRs and older adults receiving home care with chronic pain and to explore associations with clusters in both settings. METHODS We surveyed 137 NHRs and 205 older adults receiving home care. Clusters were identified using hierarchical agglomerative cluster analysis, using Ward's method with squared Euclidean distances in the proximities matrix. The clusters were characterized based on sociodemographic and clinical characteristics. Multinomial logistic regression was used to identify variables associated with different clusters. RESULTS In each setting, we identified three clusters: pain relieved, pain impaired, and suffering severe pain. In the nursing home study and home care study, respectively, the participant distributions were 46.72% and 11.71% in the pain-relieved cluster, 22.63% and 33.66% in the pain-impaired cluster, and 30.66% and 54.63% in the severe-pain cluster. Appropriate pain medication was only detected among pain-relieved NHRs. CONCLUSION Overall, differences in pain management exist within the two care settings presented here. There is potential for improvement in both settings. Moreover, there exists a need for clinical interventions aiming at shifting from pain-affected clusters to pain-relieved status.
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Affiliation(s)
- Andrea Budnick
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Ronny Kuhnert
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Arlett Wenzel
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Mimi Tse
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Juliana Schneider
- Institute of Clinical Pharmacology and Toxicology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Reinhold Kreutz
- Institute of Clinical Pharmacology and Toxicology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Dagmar Dräger
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
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DEMİR SAKA S, GÖZÜM PDS. Toplumda yaşayan yaşlılarda ağrı prevalansı ve ağrı öz yönetim uygulamaları. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.639994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Vu HTT, Mai HT, Nguyen HTT, Nguyen TTH, Nguyen TX, Nguyen TN, Pham T, Nguyen LTM, Vu GT, Pham HQ, Phan HT, Tran BX, Latkin CA, Ho CSH, Ho RCM, Nguyen AT. Older Patient Satisfaction with Chronic Pain Management in the National Geriatric Hospital in Vietnam. Patient Prefer Adherence 2020; 14:1801-1809. [PMID: 33116425 PMCID: PMC7547775 DOI: 10.2147/ppa.s265873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/22/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The high prevalence of chronic pain and difficulties in pain management in older people are challenging for healthcare providers globally. Patient satisfaction regarding pain management is one of the measures to assess efficacy of pain control as well as healthcare services. Thus, our study aimed to evaluate the older patients' satisfaction with pain management and its associated factors in Vietnam. PATIENTS AND METHODS A cross-sectional study was conducted at National Geriatric Hospital, Hanoi, Vietnam from May to October 2018. Face-to-face interviews were conducted on 495 older patients with chronic pain by using a structured questionnaire. The Pain Treatment Satisfaction Scale (PTSS) was used to assess the level of satisfaction with pain management. A Tobit regression model was used to estimate factors associated with satisfaction toward pain management. RESULTS The mean total satisfaction score was 1.77 (SD= 0.22). Older patients were most satisfied with the aspect of side effects of pain relief medication (mean=0.66, SD=0.56). On the contrary, they were most dissatisfied with information provided about pain and its treatment and efficacy of pain relief medication. Outpatients were less satisfied with information provided, the impact of current medication and pain management in general compared to inpatients. The regression model showed that patients with severe pain tended to be more dissatisfied with pain management than those with no pain. CONCLUSION This study indicated that the general satisfaction with chronic pain management in older patients was quite good especially in the aspect of pain medication's side effects. However, dissatisfactory factors remained, including information provided about pain and efficacy of current pain medication. Intensive training regarding pain in geriatric care, health education communication for older people, and improved quality of medical services should be performed to ensure the quality of pain management, especially in the older population.
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Affiliation(s)
- Huyen Thi Thanh Vu
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Hue Thi Mai
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Huong Thi Thu Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
- Correspondence: Huong Thi Thu Nguyen Scientific Research Department, National Geriatric Hospital, 1A Phuong Mai - Dong Da, Hanoi100000, VietnamTel +84 973056334 Email
| | - Thu Thi Hoai Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Thanh Xuan Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
- Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam
| | - Tam Ngoc Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Thang Pham
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | | | - Giang Thu Vu
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Hai Thanh Phan
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Roger C M Ho
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Anh Trung Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
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İlhan B, Bahat G, Erdoğan T, Kılıç C, Karan MA. Chronic pain: prevalent and independently associated with frailty and female gender in geriatric outpatients. Eur Geriatr Med 2019; 10:931-937. [PMID: 34652781 DOI: 10.1007/s41999-019-00235-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 08/29/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE This study aims to determine the prevalence and factors independently associated with chronic pain. METHODS Participants ≥ 65 years of age admitted to a geriatric outpatient-clinic were recruited between November 2012 and May 2018. Chronic pain is defined as presence of musculoskeletal system-based pain ongoing more than 3 months. Numeric rating scale (NRS) was applied to assess pain severity. Physical activity status was recorded as never or 1-2 times per week or everyday as appropriate. Following geriatric syndromes were assessed: sleep problem, fall within past year, depression by Geriatric Depression Scale Short Form (GDS-SF), frailty by FRAIL scale, functionality by modified Katz activities of daily living (ADL) and Lawton instrumental ADL scales, and quality of life by Euro-Quality of Life-5D (EQ-5D) and EQ Visual Analog Scale. RESULTS The study population consisted of 1441 patients. Of those, 969 were female and 472 were male. Mean age was 75.5 ± 6.6 years. The prevalence of chronic pain was 54.2% (n = 781). The median NRS score was 5 (1-10). Female gender, sleep problem, decreased functionality, and lower quality of life were independently associated with chronic pain after adjustment for educational status, presence of physical activity, fall within the past year, depression, and frailty. When the second analysis performed after the data with larger amount of missing value is removed, female gender and frailty remained independently associated with chronic pain. CONCLUSION Chronic pain is common and independently associated with female gender and frailty in geriatric outpatients. Factors those are associated with chronic pain, as documented in this study, may induce further longitudinal studies.
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Affiliation(s)
- Birkan İlhan
- Division of Geriatrics, Department of Internal Medicine, Dr. Ersin Arslan Training and Research Hospital, 27010, Sahinbey, Gaziantep, Turkey.
| | - Gulistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Tugba Erdoğan
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Cihan Kılıç
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Mehmet Akif Karan
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
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A Concept Analysis of Coping with Chronic Pain in Older Adults. Pain Manag Nurs 2019; 20:563-571. [DOI: 10.1016/j.pmn.2019.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 02/02/2019] [Accepted: 03/15/2019] [Indexed: 12/29/2022]
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Nawai A. Chronic Pain Management Among Older Adults: A Scoping Review. SAGE Open Nurs 2019; 5:2377960819874259. [PMID: 33415254 PMCID: PMC7774444 DOI: 10.1177/2377960819874259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 08/13/2019] [Indexed: 01/15/2023] Open
Abstract
Chronic pain is a significant problem for older adults. The effect of chronic pain on older people's quality of life needs to be described and identified. For a decade, the Roy Adaptation Model has been used extensively to explain nursing phenomena and guide nursing research in several settings with several populations. The objective of this study was to use the Roy Adaptation Model to describe chronic pain and present a systematic scoping review of the literature about the middle-range theory of chronic pain among older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses model guided a scoping review search method. A literature search was undertaken using MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Ovid, and ProQuest. The search terms were "chronic pain," "pain management," "older adult," "Roy Adaptation Model," and "a scope review." The search included articles written in English published for the period of 2004-2017. All articles were synthesized using concepts of Roy's Adaptation Model. Twenty-two studies were considered for the present review. Twenty-one articles were reports of quantitative studies, and one was a report of a qualitative study. Two outcome measures were found in this systematic scoping review. The primary outcomes reported in all articles were the reduction of pain due to interventions and an increase in coping with chronic pain. The secondary outcome measures reported in all studies were the improvement of physical function, quality of life, sleep disturbance, spiritual well-being, and psychological health related to pain management interventions among older adults. Many interventions of all studies reported improvement in chronic pain management among older adults. However, to improve chronic pain management, nurses need to understand about nursing theories, the context which instruments work, and develop empirical instruments based on the conceptual model.
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Affiliation(s)
- Ampicha Nawai
- Boromarajonani College of Nursing, Chiang
Mai, Thailand
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9
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Li J, Chen J, Qin Q, Zhao D, Dong B, Ren Q, Yu D, Bi P, Sun Y. Chronic pain and its association with obesity among older adults in China. Arch Gerontol Geriatr 2018; 76:12-18. [DOI: 10.1016/j.archger.2018.01.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/24/2018] [Accepted: 01/25/2018] [Indexed: 12/18/2022]
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Yuen JW, Tsang WW, Tse SH, Loo WT, Chan ST, Wong DL, Chung HH, Tam JK, Choi TK, Chiang VC. The effects of Gua sha on symptoms and inflammatory biomarkers associated with chronic low back pain: A randomized active-controlled crossover pilot study in elderly. Complement Ther Med 2017; 32:25-32. [DOI: 10.1016/j.ctim.2017.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 12/04/2016] [Accepted: 03/19/2017] [Indexed: 10/19/2022] Open
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Yi W, Chan A. Health Profile of Construction Workers in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1232. [PMID: 27983612 PMCID: PMC5201373 DOI: 10.3390/ijerph13121232] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/25/2016] [Accepted: 12/06/2016] [Indexed: 02/06/2023]
Abstract
Construction is a manual, heavy, and complex sector concerning the most fatal accidents and high incidence of occupational illnesses and injuries resulting in days away from work. In Hong Kong, "Pilot Medical Examination Scheme for Construction Workers" was launched in 2014 to detect the health problems of their construction workforce. All registered workers under the Construction Workers Registration Board are eligible to join the scheme. The purpose of this paper is to assess the physical condition, physiological status, and musculoskeletal disorders of 942 construction workers in Hong Kong. This study adopted a two-phase design, which includes a basic medical examination to measure the workers' physiological parameters, such as blood pressure, resting heart rate, glucose, cholesterol, uric acid, liver function test, and renal function test; as well as a face-to-face interview following the medical examination to collect their demographic information and pain experience. Individual characteristics, including gender, age, obesity, alcohol drinking habit, and sleeping habit influenced the health condition of construction workers. Among the participants, 36.1% and 6.5% of them were overweight and obese, respectively. In addition, 43.0%, 38.4%, 16.2%, and 13.9% of the participants exceeded the thresholds of cholesterol, blood pressure, urea nitrogen, and uric urea, correspondingly. Moreover, 41.0% of the participants suffered musculoskeletal pain, where the most frequent painful parts occur in the lower back, shoulder, knees, leg, and neck. Through these findings, a series of important issues that need to be addressed is pointed out in terms of maintaining the physical well-being and reducing musculoskeletal disorders of construction workers. The finding may have implications for formulating proper intervention strategies for the sustainable development of Hong Kong's construction industry.
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Affiliation(s)
- Wen Yi
- Department of Building and Real Estate, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Albert Chan
- Department of Building and Real Estate, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
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Kwok EYT, Au RKC, Li-Tsang CWP. The Effect of a Self-management Program on the Quality-of-Life of Community-dwelling Older Adults with Chronic Musculoskeletal Knee Pain: A Pilot Randomized Controlled Trial. Clin Gerontol 2016; 39:428-448. [PMID: 29471771 DOI: 10.1080/07317115.2016.1171818] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To evaluate a 6-week self-management program on pain conducted in a mobile setting at the residences of older adult participants. METHODS In this single-blinded randomized controlled trial, 46 community-dwelling older adults with chronic knee pain were randomly assigned to the experimental (n = 19) and wait-list control groups (n = 27). The experimental group engaged in the 6-week program while the control group was only given some pamphlets on exercise and joint care. The pain level, physical functions, QOL, and self-efficacy of the participants in both groups were assessed at baseline, post-program, and at the 1-month follow-up session. Both baseline and post-program (or post-control-period assessment) data were analyzed. RESULTS The results showed that the participants in the experimental group had a higher level of self-efficacy, better performance in walking test, a higher level of quality-of-life, and less frequency of pain at the post-program follow-up as compared to the control group. The effect was maintained among the experimental group at post-4-week follow-up and further reduction in pain was detected. CONCLUSIONS The program appeared to be effective at improving the pain status, self-efficacy, functional performance, and quality-of-life of older adults. However, as the sample size was small, further study is suggested to investigate the effects of the program.
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Affiliation(s)
- Esther Y T Kwok
- a The Hong Kong Polytechnic University , Hung Hom , Hong Kong , China
| | - Ricky K C Au
- a The Hong Kong Polytechnic University , Hung Hom , Hong Kong , China
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Oude Engberink A, Lognos B, Badin M, Carbonnel F, Lalau M, Blain H, Bourrel G. [Primary care pain management in the elderly population: The opening to non-pharmacological interventions. Qualitative study focused on GP experiences]. Presse Med 2016; 45:e377-e387. [PMID: 27597302 DOI: 10.1016/j.lpm.2016.01.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 11/19/2015] [Accepted: 01/04/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES First of all, understand the management of pain in the elderly population through GP experiences and, secondly, explore their implication to the benefit of well aging. METHOD Qualitative study with data collection combining 2 focus groups and 5 in depth interviews centered on the lived experience of 16 GPs in the Languedoc-Roussillon region in southern France. A semiopragmatic phenomenological analysis of the fully transcribed verbatim interviews was used to establish the significant categories in relation with our objectives. RESULTS The GPs feel that the pain management still needs improvement even though it has become one of their priorities. GPs often notice iatrogenic effects in the care taking process of multiple pathologies which make them choose for the use of non-pharmacological interventions. The complex nature of pain, which has multiple significations for the elderly population, needs an overall approach by the GPs. They feel that it's their job to manage this because of the proximity and knowledge of the patient and his weaknesses. For them, aging well is a patient experience, they are only a support in this process. DISCUSSION GPs think that they are expert in the complex process of pain management. This process has to be seen in a multidimensional approach of an older person with multiple pathologies. Therefore, they make use of non-pharmacological interventions. CONCLUSION These interventions need to be developed to improve the quality of life in the elderly population.
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Affiliation(s)
- Agnes Oude Engberink
- Département de médecine générale, faculté de médecine de Montpellier, Nîmes, France; CEPS Platform, university of Montpellier, France.
| | - Beatrice Lognos
- Département de médecine générale, faculté de médecine de Montpellier, Nîmes, France; CEPS Platform, university of Montpellier, France
| | - Melanie Badin
- Département de médecine générale, faculté de médecine de Montpellier, Nîmes, France
| | - François Carbonnel
- Département de médecine générale, faculté de médecine de Montpellier, Nîmes, France; CEPS Platform, university of Montpellier, France
| | - Marion Lalau
- Département de médecine générale, faculté de médecine de Montpellier, Nîmes, France
| | - Hubert Blain
- Département de gérontologie, CHRU de Montpellier, France
| | - Gérard Bourrel
- Département de médecine générale, faculté de médecine de Montpellier, Nîmes, France; CEPS Platform, university of Montpellier, France
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Eckerblad J, Theander K, Ekdahl AW, Jaarsma T. Symptom trajectory and symptom burden in older people with multimorbidity, secondary outcome from the RCT AGe-FIT study. J Adv Nurs 2016; 72:2773-2783. [PMID: 27222059 DOI: 10.1111/jan.13032] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2016] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to follow the symptom trajectory of community-dwelling older people with multimorbidity and to explore the effect on symptom burden from an ambulatory geriatric care unit, based on comprehensive geriatric assessment. BACKGROUND Older community-dwelling people with multimorbidity suffer from a high symptom burden with a wide range of co-occurring symptoms often resulting to decreased health-related quality of life. There is a need to move from a single-disease model and address the complexity of older people living with multimorbidity. DESIGN Secondary outcome data from the randomized controlled Ambulatory Geriatric Assessment Frailty Intervention Trial (AGe-FIT). METHODS Symptom trajectory of 31 symptoms was assessed with the Memorial Symptom Assessment Scale. Data from 247 participants were assessments at baseline, 12 and 24 months, 2011-2013. Participants in the intervention group received care from an ambulatory geriatric care unit based on comprehensive geriatric assessment in addition to usual care. RESULTS Symptom prevalence and symptom burden were high and stayed high over time. Pain was the symptom with the highest prevalence and burden. Over the 2-year period 68-81% of the participants reported pain. Other highly prevalent and persistent symptoms were dry mouth, lack of energy and numbness/tingling in the hands/feet, affecting 38-59% of participants. No differences were found between the intervention and control group regarding prevalence, burden or trajectory of symptoms. CONCLUSIONS Older community-dwelling people with multimorbidity had a persistent high burden of symptoms. Receiving advanced interdisciplinary care at an ambulatory geriatric unit did not significantly reduce the prevalence or the burden of symptoms.
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Affiliation(s)
- Jeanette Eckerblad
- Department of Social and Welfare Studies, Faculty of Medicine and Health Sciences, Linkoping University, Sweden.
| | - Kersti Theander
- Faculty of Health, Science and Technology, Department of Health Sciences, Nursing, Karlstad University, Sweden
| | - Anne W Ekdahl
- Department of Research and Education, Helsingborg Hospital, Sweden.,Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Tiny Jaarsma
- Department of Social and Welfare Studies, Faculty of Medicine and Health Sciences, Linkoping University, Sweden
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Health-Related Quality of Life and Pain Intensity Among Ethnically Diverse Community-Dwelling Older Adults. Pain Manag Nurs 2015. [PMID: 26206611 DOI: 10.1016/j.pmn.2015.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Chronic pain is highly prevalent in older adults and often negatively associated with health-related quality of life (HRQoL). This study compared HRQoL, including physical health and mental health, in persons of differing ethnicities, and identified factors associated with pain intensity and HRQoL in ethnically diverse older adults. Older adults with chronic pain from four ethnic groups (African Americans, Afro-Caribbeans, Hispanics, and European Americans) were recruited from the Florida Atlantic University Healthy Aging Research Initiative (HARI) registry. The Medical Outcomes Study Short Form-36 (SF-36) was used to evaluate HRQoL, including functional status, emotional well-being, and social functioning. Of 593 persons in the four ethnic groups in the registry, 174 met the inclusion criteria (pain level of four or higher on an 11-point scale, lasting 3 months or longer). Among these 174, African Americans reported the highest level of pain intensity, followed by Afro-Caribbeans, Hispanics, and European Americans. Hispanics reported the highest physical health scores and the lowest mental health scores. In contrast, African Americans reported the highest mental health scores and the lowest physical health scores. Multivariate linear regression analysis revealed that ethnicity, lower physical health scores, and lower mental health scores were significantly (p ≤ .01) associated with pain intensity. Understanding ethnic variations in response to pain intensity may address gaps in knowledge about HRQoL to reduce disparities in optimal care. Health care providers should consider ethnic norms and cultural diversity to provide optimal interventions for this population.
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A Systematic Review of the Prevalence and Measurement of Chronic Pain in Asian Adults. Pain Manag Nurs 2014; 16:440-52. [PMID: 25439125 DOI: 10.1016/j.pmn.2014.08.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 08/13/2014] [Accepted: 08/15/2014] [Indexed: 11/23/2022]
Abstract
There are limited epidemiologic studies on chronic pain in Asian populations. The aim of this review was to gather all epidemiologic studies of chronic pain in Asian countries and systematically describe the measurement and prevalence of chronic pain in Asian adults. A systematic review was performed using PubMed, MEDLINE, EMBASE, Psych INFO, Cochrane Database for Systematic Review, and CINAHL. Additional studies were identified manually by searching bibliographies. We identified 19 relevant articles for this review. Most articles used the definition of chronic pain set by the International Association for the Study of Pain. The majority of the articles used simple single-question methods to measure chronic pain. The prevalence of chronic pain among Asian adults ranges from 7.1% (Malaysia) to 61% (Cambodia and Northern Iraq), whereas among the Asian geriatric population, the prevalence is even higher and ranges from 42% to 90.8%. This review showed that there is great variation in the reported prevalence of chronic pain in Asian adults and the prevalence of chronic pain is high among the Asian geriatric population. To measure the distribution of chronic pain in adults, a uniform measurement strategy should be adopted.
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Mohamed Zaki LR, Hairi NN. Chronic pain and pattern of health care utilization among Malaysian elderly population: National Health and Morbidity Survey III (NHMS III, 2006). Maturitas 2014; 79:435-41. [PMID: 25255974 DOI: 10.1016/j.maturitas.2014.08.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 08/11/2014] [Accepted: 08/27/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aims of this study were to report prevalence of chronic pain and to examine whether chronic pain influence healthcare usage among elderly Malaysian population. METHODS This was a sub-population analysis of the elderly sample in the Malaysia's Third National Health and Morbidity Survey (NHMS III) 2006, a nation-wide population based survey. A subset of 4954 elderly aged 60 years and above was used in the analysis. Chronic pain, pain's interference and outcome variables of healthcare utilization (hospital admission and ambulatory care service) were all measured and determined by self-report. RESULTS Prevalence of chronic pain among elderly Malaysian was 15.2% (95% CI: 14.5, 16.8). Prevalence of chronic pain increased with advancing age, and the highest prevalence was seen among the old-old group category (21.5%). Across young-old and old-old groups, chronic pain was more prevalent among females, Indian ethnicity, widows/widowers, rural residency and those with no educational background. Our study showed that chronic pain alone increased hospitalization but not visits to ambulatory facilities. Presence of chronic pain was significantly associated with the frequency of hospitalization (aIRR 1.11; 95% CI 1.02, 1.38) but not ambulatory care service. CONCLUSIONS Chronic pain is a prevalent health problem among the elderly in Malaysia and is associated with higher hospitalization rate among the elderly population. This study provides insight into the distribution of chronic pain among the elderly and its relationship with the patterns of healthcare utilization.
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Affiliation(s)
- Lily R Mohamed Zaki
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Julius Centre University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Noran N Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Julius Centre University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Tse MMY, Lee PH, Ng SM, Tsien-Wong BK, Yeung SSY. Peer volunteers in an integrative pain management program for frail older adults with chronic pain: study protocol for a randomized controlled trial. Trials 2014; 15:205. [PMID: 24894436 PMCID: PMC4055794 DOI: 10.1186/1745-6215-15-205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 05/20/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic pain is common among the older population. A literature review on pain management program showed that exercise, yoga, massage therapy, Tai Chi, and music therapy could significantly reduce pain. In spite of the proven benefits of pain management programs, these intervention programs were effective only in the short term, and older adults would resume their old habits. It has been suggested that interventions comprising some type of social support have great potential to increase the participation of older adults. Therefore, we propose the inclusion of peer volunteers in an integrated pain management program to relieve pain among frail older adults. This study aims to explore the effectiveness of an integrated pain management program supplemented with peer volunteers in improving pain intensity, functional mobility, physical activity, loneliness levels, happiness levels, and the use of non-pharmacological pain-relieving methods among frail older adults with chronic pain. METHODS/DESIGN We intend to recruit 30 nursing home residents and 30 peer volunteers from the Institute of Active Ageing in Hong Kong in a group trial for an 8-week group-based integrated pain management program. There will be 16 sessions, with two 1-hour sessions each week.The primary outcome will be pain levels, while secondary outcomes will be assessed according to functional mobility, physical activity, loneliness levels, happiness levels, the use of non-pharmacological pain-relieving methods, and through a questionnaire for volunteers. DISCUSSION In view of the high prevalence of chronic pain among older adults and its adverse impacts, it is important to provide older adults with tools to control their pain. We propose the use of peer volunteers to enhance the effects of an integrated pain management program. It is expected that pain can be reduced and improvements can be achieved among older adults in the areas of physical activity, functional mobility, loneliness levels, happiness levels, and the use of non-pharmacological pain relieving methods. Using these results, we will assess the need to conduct a larger study with a randomized controlled design. TRIAL REGISTRATION This trial was registered on 24 February 2014 at the Australian New Zealand Clinical Trials Registry (ANZCTR) with the trial number: ACTRN12614000195651.
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Affiliation(s)
- Mimi Mun Yee Tse
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
| | - Paul Hong Lee
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
| | - Sheung Mei Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
| | - Bik Kwan Tsien-Wong
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
| | - Suey Shuk Yu Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
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Byma EA, Given BA, Given CW. Longitudinal differences in pain among older adult Home and Community Based Waiver Program participants in relation to diagnosis of cancer. Home Health Care Serv Q 2014; 32:249-66. [PMID: 24372477 DOI: 10.1080/01621424.2013.851051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Generalized estimating equation analyses models were used to examine the longitudinal association between pain and diagnosis of cancer among older adult, Home and Community Based Waiver Program participants. Daily pain was reported by over half, with 29% experiencing daily pain that was unusually intense. Diagnosis of cancer was a significant predictor of daily pain only as an interaction term with cognitive impairment. Being female, having a medical diagnosis of depression, or increasing measure of comorbid conditions significantly increased the likelihood of daily pain. In comparison, increasing age, being of African American, Hispanic, or "other" race resulted in a significantly decreased likelihood of daily pain.
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