S1.2 Promotion of health, active aging and quality of life among older adults living with pain
Promotion of health, active ageing and quality of life among older adults living with pain
Chair: Sara Cederbom
Research shows that 45-80% of the general population of older adults report that they have experiences of pain and it is obvious that pain is a major health issue for the target population. To live with pain affects the whole life, both physically, psychologically and socially, which in the end lead to a lower quality of life and reduce the possibility to have an active ageing. The objective of this symposium is to highlight how we can promote health and active ageing for this target population from different perspectives.
S1.2.1 Gender perspectives on pain among older adults
Lena Sandin Wranker
Lund University, Sweden
Background and aims: Pain is a multidimensional, unpleasant experience that is common among elderly. Its relationship with ageing is unclear. The purpose of the studies was to, from a gender perspective, (I) investigate pain prevalence and estimated pain intensity, (II) study factors that affect the relationship between pain and quality of life, (III) possible association between personality traits and pain, (IV) changes in pain over a nine-year period and V) pain and quality of life in family caregivers (60+). Methods: Participants, aged 60 years and older (n=1402), were recruited from the baseline investigation (2001-2003) of the Swedish National study on Aging and Care - Blekinge (SNAC-B), (n=1402), (study I, II, III). In study (IV) only those who were older than 72 years at inclusion, (n=1005), and who also went through the reinvestigation nine years later, (n=328), was included. For the study of caregivers (V), participants were recruited from baseline in SNAC-B (n=1402) and Gott Åldrande i Skåne (Gås) (n=2931). Results: Almost 55% of the participants reported pain, predominantly women, (p<0.01).Women scored pain intensity higher than men (p<0.023). Among women, the strongest OR for low QoL was found for pain (OR 2.27, CI 1.36-3.78) in contrast to men who mor often suffer from insomnia (OR 1.86, CI 1.04-3.33). Personality traits and pain were related. Low external locus of control scores may contribute to pain relief among men. Pain may contribute to premature death. The prevalence of pain was similar among caregivers and those who are not giving care. Conclusion: Pain is common in the aging population but declines with increasing age, perhaps as a result of the pain leading to premature death. There are gender differences in how pain influences quality of life. Low external locus of control scores may contribute to pain relief among men. Caregivers report pain to about the same extent as non-caregivers.
S1.2. 2 STRENGTH: Promoting health for older adults living with pain at home
University of Skövde, Sweden
Background and aims: Long-term musculoskeletal pain is a global and one of the most pervasive and disabling health problem with a negative impact on health and quality of life among older adults. Research show that the overall orientation and first priority for older adults living at home with musculoskeletal pain is foremost to develop their own approach in how to deal with pain and continue daily living despite pain and not the pain itself. Many experience a lack of professional guidance and feel forced into learning to live with pain on their own. They need to become their own coaches, use self-talk and learn through trial and error to balance daily life with pain. They focus on capturing, enjoying and valuing moments of pleasure which help them to find meaning and strength in life. The older adults’ need of support and focus on joy and meaning in life was addressed in the method Reflective STRENGTH-giving dialogue (STRENGTH). The method was developed by Berglund and Gillsjö to be learned and used by health care professionals to individually and holistically meet older adults’ needs in a way that promotes health, well-being, meaning and strength in life. Methods: Health care professionals (10) were educated and continuously supervised in an intervention study in which they carried out Reflective STRENGTH –giving dialogues with 20 community dwelling older adults living with pain at home. Qualitative interviews were conducted before and after from a lifeworld research approach. Results: Essential were the older adults suffering in silence before the intervention. They experienced not being taken seriously and tried to endure and distract themselves from pain and avoided thoughts about the future. A trustful and continuous relationship developed in the dialogues, pain was alleviated and the loneliness diminished. The dialogues were experienced as a new way of talking about life with pain. A transfer of orientation in life occurred, from past towards present and the future, and from hindrances to opportunities. Increased joy and engagement and motion in life was shown. Conclusion: The dialogues helped to increase the older adults’ sense of security, courage, strength and meaning in life which implies that STRENGTH is a method with potential to promote and enhance health and active ageing among older adults living at home with pain.
S1.2.3 To promote an active ageing among older women living with pain, using a behavioural medicine approach in physiotherapy
OsloMet – Oslo Metropolitan University (formerly Oslo and Akershus University College of Applied Sciences), Norway
Background and aims: To live with pain as an older adult is shown to be associated with various pain-related disabilities in everyday life, especially in women. In the end this affects the possibility to perform everyday activities and experience an active ageing. The aim of the studies was, from a behavioural medicine approach in physiotherapy, to explore how older women, living with pain, describe their ability to perform everyday activities and what could promote their ability to perform those activities, how home-help service staff describe their role to promote everyday activities and to explore the feasibility and effect of an intervention. Methods: Participants, women aged 65 years and older, experiencing long-term pain, living alone and dependent on formal care to manage their everyday life. The data collection consisted of an interview study with 12 women, three focus-group interviews with home-help service staff and a feasibility study with 23 participants. Results: The results show that it was very important for the older women to perform everyday activities, both for their physical and mental health. A key factor in promoting the ability to perform everyday activities was to have a daily r in a supportive environment, which included home help service staff. The interviews with the staff showed that they had a strong will and desire to promote their care recipients’ independence and quality of life. The intervention was feasible to implement for the target population and implies that levels of physical activity, self-efficacy in relation to exercise and management of everyday life can be improved. Conclusion: The results shows how important it is for the target population to live an active life, despite the pain, and how a behavioural medicine approach in physiotherapy can increase the possibility to endure an active ageing for older women living with long-term pain.