Chronic pain as perceived by older people: a qualitative study

Background: the practical issues confronting older people who suffer chronic pain may not be tackled in a pain clinic setting and little is known of their strategies for coping. They seem to have little or no information on how to improve the quality of their lives or on resources available to them. Aim: the aim of this study was to ascertain from older people the practical, physical and psychosocial limitations they faced because of chronic pain, and the strategies they used to deal with them. Method: a qualitative approach to generating data was chosen using a Grounded Theory approach and unstructured interviews. Sixty-three people ranging from 60 to 87 years of age participated in the study. Audio-tapes were transcribed verbatim. The material was coded and collapsed into themes. Results: two main themes emerged: (i) the desire for independence and control; and (ii) adaptation to a fife with chronic pain. The valuing of independence is in fine with previous findings. With only three exceptions none of the participants were certain how or where to get help with practical issues and so they lived in fear of loss of their independence. Several subcategories formed the theme of adaptation. These were acceptance and non-acceptance, pacing oneself, helping other people, the use of prayer and 'looking good and feeling good'. When independence and control is effective, older people may adapt better to chronic pain. Conclusion: understanding chronic pain sufferers from their own perspective may have important clinical implications. The interview data informed the development of a booklet designed to meet the needs of older patients with chronic pain.