‘Older Adults Pain Self-management’: Exploring What We Mean Through Concept Analysis

Carrie Stewart BSc.Aberdeen Pain Research Collaboration, Centre of Academic Primary Care, University of Aberdeen, UK.

Background

No standard definition exists for the concept ‘chronic pain self-management’ or how it should be defined in relation to older adults. Poorly defined concepts can result in misunderstandings in the clinical setting, and can hinder research through difficulties identifying or measuring the concept.

Aim

To systematically analyse existing use and understanding of the concept ‘older adults pain self-management’ and develop a theoretical definition based on: Contextual Use, Essential attributes, Antecedents, Consequences, Related and Surrogate concepts.

Method

Design: Rodgers Evolutionary Model of Concept AnalysisSources: Medline (Ovid), Cinahl, AMED, PsychLit, Health policy guidelines, Professional & patient educationSearch Terms Included: chronic pain, arthritis, self management, self care, self help, patient education, self efficacy and copingInclusion: Must meet basic and broad definition for pain self-management, focus on management of musculoskeletal chronic pain and older adults (65yrs+)Exclusion: non-musculoskeletal pain (i.e. cancer pain)Sample: N=45 (agreement between 2 reviewers )Analysis: Thematic analyses framework.

Results Context: Discussed as an Intervention, Everyday behaviours & Outcome/goal.Essential attributes: Multi-dimensional, Process, Personal development, Active individuals, Symptom response and Symptom control. Related Concepts: Pain coping and Health education. Antecedents: Perceived need, Support, Activated patientsConsequences: Range of bio-psycho-social health improvementsSurrogate Concepts: Self-help, Self-careUncertainties: Little consideration in the literature as to how this concept is used and understood in everyday life.

Conclusion

“Older adults pain self-management is a multi-dimensional process prompted by an individuals recognition for the need for, their desire to, and ability to self-manage pain with support from others. Individuals become active in their care through developing and using many skills to assist them in responding to and controlling pain and its related symptoms. Pain self-management seeks improvement in a range of biological, psychological and social outcomes, with specific goals set by the individual.”

This theoretical definition is formed from research driven definitions. There is a need to explore how older adults and professionals experience pain self-management in everyday use.

EOPICEngaging with older people and their carers to develop interventions for the self-management of chronic pain

Older Adults Pain Self-

management

Symptom Response

Symptom Control

Active Individuals

Personal Development

ConsequencesBio-Psycho-Social

Health Improvement

AntecedentsPerceived Need,

Support & Activated Patient

Pain Coping

Health Education