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Worldwide, there is an increasing number of older adults, the majority of whom remain living at home. Not infrequently they live with long-term pain, especially musculoskeletal pain, which is associated with increased disability physical, psychological, social and a negative impact on quality of life. A deeper understanding of how older adults experience living with this type of pain is needed in order to improve well-being and quality of life.
The study focused on the actual experience by living with this global, prevailing and disabling type of pain. The aim was to describe commonalities in how older adults endure long-term musculoskeletal pain in their daily life at home. This inductive, descriptive study included qualitative semi-structured face-to-face interviews with 19 participants 66 to 88 years in their homes.
Interviews were audio recorded and transcribed verbatim. In time, they learned that: This experience was dominated by learning. The approaches generated to learn to endure ely in daily living by these participants should be discussed with older adults in similar situations for further additions, refinements and validation. Ann Jose ankara escort. Home Publications Conferences Register Contact. Guidelines Upcoming Special 199913. Research Article Open Access.
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Musculoskeletal pain is the most common long-term pain for older adults living in their homes [ 1 – 3 ]. There is an increase worldwide leh musculoskeletal conditions accompanied with this type of pain. There is an extensive literature about long-term musculoskeletal pain as a major health problem among older adults lsy 1 – 36 – 14 ]. The prevalence of this type of pain tends to increase with increasing age [ 315 ].
Musculoskeletal pain is associated with lower level of physical activity [ 16 ], increased risk of disabilities in daily living [ 617 – 23 ] including sleeping difficulties [ 24 ], increasing risk of falls [ 2526 ], depressive symptoms [ 2728 ] and impaired quality of life in relation to leg and well-being [ 28 – 31 ].
To-date researchers have focused primarily on the prevalence and nature of the pain, its treatment and impact rather than on how community dwelling older adults actually experience living with the pain at home. How do older adults endure long term musculoskeletal pain that have lasted at least for 6 months in their daily let at home? This question needs to be addressed in order to help health pey providers tailor individualized care to preserve and promote health and well-being in this population.
Qualitative pey that focus on how older adults 65 and older actually live with musculoskeletal pain at home are highly limited.
Most studies have been quantitative and the focus has been mainly on older adults in assisted living facilities, although a few have included community dwelling older adults.
Recently a small group of researchers have begun to use qualitative research methods to explore the perceptions and experiences of community dwelling older adults living with long-term pain. These older adults strived for independence and control and tried to adapt to a life with pain.
They identified five coping strategies, including tuning controlling the body movement until the pain goes awayattention diversion, exercise, medical regime and giving up control. Blomqvist and Edberg [ 34 ] interviewed 90 older adults about their experience of living with long term pain at home or in a sheltered accommodation and dependent on home health care providers in daily life.
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Some of the older adults expressed satisfaction in their situation in spite of pain and viewed themselves, their pain and significant others positively whereas others expressed dissatisfaction with a negative connotation in life. The need for additional research has been argued by Helme and Gibson [ 35 ]. They highlighted the difficulty in obtaining in depth data of this experience with the commonly used designs and questionnaire 199113. Furthermore, Miaskowski [ 36 ] and Gartrell [ 37 ] have stated that researchers need to be attentive to how older adults experience of pain and the distress and disabilities in life related to this health problem.
Face-to-face interviews were completed with 19 community dwelling older adults 119913 with long-term musculoskeletal pain in their home.
The goal was to capture this experience as fully as possible 1913 regard to both variations and commonalities.
An initial phenomenographic analysis was completed in order to describe the different ways in which older adults deal with daily life while living with long-term musculoskeletal pain at home.
The result of this analysis has been published [ 38 ]. Daily life for all the adults was an act of endurance and there were important commonalities in how they endured the pain. Based on the studies reviewed and the conducted analysis the aim of this analysis was to describe commonalities in how older adults endure long-term musculoskeletal pain in their daily life at home.
Content analysis as a research method was developed originally as a quantitative research method in several disciplines during the 20th century. More recently a qualitative type of content analysis was added [ 42 ]. Graneheim and Lundman [ 41 ] developed a qualitative style of content analysis that is interpretive in nature and used to describe or illuminate a phenomenon by identifying both the manifest the obvious and latent underlying meaning content in a text.
This approach remains close to the languages used by participants, rather than the more traditional, realist approach which focuses on single words and phrases [ 43 ]. The inclusion criteria for this study were community dwelling older adults aged 65 or above, who for at least the past six months, had lived with long-term persistent or regularly recurring musculoskeletal pain at home and had received home health care services. In addition they had to be willing to participate in the study and be able to understand and answer questions.
The older adults who met the inclusion criteria were identified by the home health care providers in their community. They were given an informational letter about the study and asked if they would be willing to be contacted by the first author. Each potential participant was contacted by the first author by phone to answer any questions and to give more detailed information.
A sample of 19 older adults, 18 women and one man, aged 66 to 88 years, mean 79 yearsfrom three different communities in Sweden participated in the study. Five were married, 12 widowed and two were divorced.
The older adults had lived with long-term musculoskeletal pain ranging from two to 50 years and one woman had lived with this type of pain for about 75 years, almost her entire lifetime. Semi-structured, face to face interviews were conducted and carried out as a conversation by the first author in the year of This researcher is an experienced registered nurse with a post graduate diploma as a public health specialist in nursing, and family nurse practitioner with a master of science in nursing and doctoral prepared in qualitative research method.
The researcher had no personal relation with the participants. The interview, conveyed as a conversation allowed the older adults to reflect upon and articulate their experiences in their situation and to choose what content to share with the researcher.
The interview guide consisted of open ended questions with subsequent follow up questions used to explore and describe how each participant lived with long-term musculoskeletal pain in their daily life. More specifically, it consisted of a series of questions covering older adults general description of their pain, how they lived with it in daily life, its influence on their daily lives, how they dealt with daily life while living with this type of pain, contacts and support from health care providers and significant others and their thoughts about the future.
Interviews lasted from 35 to minutes. They were audio-recorded and transcribed verbatim. There were six major steps in the analysis.
First the transcripts of all the interviews were read by the first author to become familiar with the text and to reflect upon the content.
The second reading was 91913 to confirm the aspect of enduring long-term musculoskeletal lej in daily life at home which constituted the foundation for the research question: What are the commonalities in how older adults endure lwy musculoskeletal pain in their daily life at home? Thirdly, each interview was read and re-read to identify the content relevant to the research question. As a fourth step, meaning units consisting of words, sentences or paragraphs related to the aim were identified in the interviews.
The meaning units constituted the foundation for condensation and abstraction into codes conducted separately for each interview. In the fifth step, the meaning units were condensed and the essential contents in the condensed meaning units were abstracted and labeled with a code. In the sixth step, the codes were compared for similarities and differences in content and sorted into five preliminary themes: Each code, explicitly manifest content or implicitly latent contentreflected the theme it was sorted into.
The codes in the preliminary theme: During the analysis the component learning to endure pain, in one of the preliminary themes was interpreted as an underlying thread across all the five preliminary themes. Based on this interpretation, learning to live with pain was labeled as the main theme under which the remaining five preliminary themes were subsumed.
The first and second author, an experienced professor and researcher on the topic of pain in hospital and home settings and an expert in qualitative methods, analyzed the first interview separately, compared, discussed and reached consensus about codes and potential themes. The first author continued to analyze the following interviews and each analysis condensations, codes and preliminary themes were discussed.
There was close communication between the first and second author in the phase of labeling codes, sorting them into preliminary themes and naming final themes. The analysis was an iterative process back and forth across the steps and not in a linear process as might be understood from the description above.
The study was approved by the Ethics Committee at the University of Gothenburg, In addition, approvals were given by the heads of the social welfare and home health care services in the communities of concern for the study.
Furthermore, the older adults consented to participate in the study both verbally and in writing. Several reminders were given prior to the interview that participation in the lej was voluntary.
The community dwelling older adults in this study felt that they were forced to endure pain in their daily lives at home.
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They felt that their pain could not be eliminated, controlled nor managed. Instead, the 1913 was how to endure living with it? In 1913 interviews many of the older adults referred explicitly, others implicitly that they let to learn to live with the pain. Thus learning to live with pain became the main theme. The five sub-themes reflected how these adults had learned to endure pain in their daily life, continue with daily activities and find meaning in life.
Main and sub-themes are described below and illuminated with quotes from the interviews. The quotes collectively stem from 10 interviews. These were the most illustrious. However, every interview was reread to make sure that the illustrious quote was synonymous with the text in the interviews. For the older adults in this study, the pain was continuously ongoing and no one expressed any belief in the possibility that it could be eliminated or controlled.
They had come to believe that they just had to learn how to endure. I have no more wish, not for me at least, one just has to endure. The 19193 adults could not recall ever having been taught how to endure.