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Open Access Highly Accessed Research article

“I feel so stupid because I can’t give a proper answer…” How older adults describe chronic pain: a qualitative study

Amanda Clarke1*, Geraldine Anthony2, Denise Gray3, Derek Jones1, Paul McNamee3, Patricia Schofield4, Blair H Smith2 and Denis Martin5

Author Affiliations

1 Faculty of Health and Life Sciences, Coach Lane Campus, Northumbria University, Benton, Newcastle upon Tyne, NE7 7XA, USA

2 University of Dundee, Medical Research Institute, Division of Population Health Sciences, Dundee, UK

3 University of Aberdeen, School of Medicine, Aberdeen, UK

4 University of Greenwich, School of Health and Social Care, Greenwich, UK

5 University of Teesside, School of Health and Social Care, Teesside, UK

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BMC Geriatrics 2012, 12:78  doi:10.1186/1471-2318-12-78

Published: 31 December 2012

Abstract

Background

Over 50% of older adults experience chronic pain. Poorly managed pain threatens independent functioning, limits social activities and detrimentally affects emotional wellbeing. Yet, chronic pain is not fully understood from older adults’ perspectives; subsequently, pain management in later life is not necessarily based on their priorities or needs. This paper reports a qualitative exploration of older adults’ accounts of living with chronic pain, focusing on how they describe pain, with a view to informing approaches to its assessment.

Methods

Cognitively intact men and women aged over sixty-five who lived in the community opted into the study through responding to advertisements in the media and via contacts with groups and organisations in North-East Scotland. Interviews were transcribed and thematically analysed using a framework approach.

Results

Qualitative individual interviews and one group interview were undertaken with 23 older adults. Following analysis, the following main themes emerged: diversity in conceptualising pain using a simple numerical score; personalising the meaning of pain by way of stories, similes and metaphors; and, contextualising pain in relation to its impact on activities.

Conclusions

The importance of attending to individuals’ stories as a meaningful way of describing pain for older adults is highlighted, suggesting that a narrative approach, as recommended and researched in other areas of medicine, may usefully be applied in pain assessment for older adults. Along with the judicious use of numerical tools, this requires innovative methods to elicit verbal accounts, such as using similes and metaphors to help older adults describe and discuss their experience, and contextualising the effects of pain on activities that are important to them.

Keywords:
Older adults; Ageing; Qualitative research; Stories; Metaphors; Chronic pain; Community