"I try and smile, I try and be cheery, I try not to be pushy. I try to say 'I'm here for help' but I leave feeling... worried": a qualitative study of perceptions of interactions with health professionals by community-based older adults with chronic pain

Amanda Clarke; Denis Martin; Derek Jones; Patricia Schofield; Geraldine Anthony; Paul McNamee; Denise Gray; Blair H. Smith

doi:10.1371/journal.pone.0105450

"I try and smile, I try and be cheery, I try not to be pushy. I try to say 'I'm here for help' but I leave feeling... worried": a qualitative study of perceptions of interactions with health professionals by community-based older adults with chronic pain

Amanda Clarke, Denis Martin, Derek Jones, Patricia Schofield, Geraldine Anthony, Paul McNamee, Denise Gray, Blair H. Smith

Research output: Contribution to journal › Article › peer-review

30 Citations (Scopus)

Abstract

BACKGROUND: Over 50% of community-dwelling older adults experience chronic pain, which threatens their quality of life. Of importance to their pain management is older people's interaction with health professionals that, if unsatisfactory, may impair the outcome.

AIMS: To add to the limited research specific to older people living with chronic pain in the community, we explored how they perceive their experiences of interacting with health professionals, seeking factors that might optimise these interactions.

METHODS: Purposive sampling was used to recruit men and women >65 years with self-reported musculoskeletal chronic pain. Qualitative individual interviews and one group interview were undertaken with 23 participants. Data were transcribed verbatim and underwent Framework Analysis.

RESULTS: Three themes were identified. Seeking help illustrates issues around why older people in the community may or may not seek help for chronic pain, and highlights the potential involvement of social comparison. Importance of diagnosis illustrates the desire for professional validation of their condition and an aversion to vague explanations based on the person's age. Being listened to and being heard illustrates the importance of empathic communication and understanding expectations, with due respect for the person's age.

CONCLUSIONS: In common with people of all ages, an effective partnership between an older person in pain and health professionals is essential if pain is to be reported, appropriately assessed and managed, because of the subjective nature of pain and its treatment responses. For older people with pain, perception about their age, by both parties in the partnership, is an additional factor that can unnecessarily interfere with the effectiveness of this partnership. Health professionals should engage with older adults to clarify their expectations about pain and its management, which may be influenced by perceptions about age; and to encourage expression of their concerns, which may also be affected by perceptions about age.

Original language	English
Article number	e105450
Pages (from-to)	1-7
Number of pages	7
Journal	PloS ONE
Volume	9
Issue number	9
DOIs	https://doi.org/10.1371/journal.pone.0105450
Publication status	Published - 4 Sept 2014

Bibliographical note

Funding: This study was funded by the Medical Research Council as part of the Lifelong Health and Wellbeing programme. The funders had no role in the design, execution, analysis and interpretation of the data, or writing of the study.

We are grateful to the lay members of our Advisory Group and to the
individuals who took part in the interviews.

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10.1371/journal.pone.0105450Licence: CC BY

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Clarke, A., Martin, D., Jones, D., Schofield, P., Anthony, G., McNamee, P., Gray, D., & Smith, B. H. (2014). "I try and smile, I try and be cheery, I try not to be pushy. I try to say 'I'm here for help' but I leave feeling... worried": a qualitative study of perceptions of interactions with health professionals by community-based older adults with chronic pain. PloS ONE, 9(9), 1-7. Article e105450. https://doi.org/10.1371/journal.pone.0105450

"I try and smile, I try and be cheery, I try not to be pushy. I try to say 'I'm here for help' but I leave feeling... worried": a qualitative study of perceptions of interactions with health professionals by community-based older adults with chronic pain. / Clarke, Amanda; Martin, Denis; Jones, Derek et al.
In: PloS ONE, Vol. 9, No. 9, e105450, 04.09.2014, p. 1-7.

Research output: Contribution to journal › Article › peer-review

Clarke, A, Martin, D, Jones, D, Schofield, P, Anthony, G, McNamee, P, Gray, D & Smith, BH 2014, '"I try and smile, I try and be cheery, I try not to be pushy. I try to say 'I'm here for help' but I leave feeling... worried": a qualitative study of perceptions of interactions with health professionals by community-based older adults with chronic pain', PloS ONE, vol. 9, no. 9, e105450, pp. 1-7. https://doi.org/10.1371/journal.pone.0105450

Clarke A, Martin D, Jones D, Schofield P, Anthony G, McNamee P et al. "I try and smile, I try and be cheery, I try not to be pushy. I try to say 'I'm here for help' but I leave feeling... worried": a qualitative study of perceptions of interactions with health professionals by community-based older adults with chronic pain. PloS ONE. 2014 Sept 4;9(9):1-7. e105450. doi: 10.1371/journal.pone.0105450

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abstract = "BACKGROUND: Over 50% of community-dwelling older adults experience chronic pain, which threatens their quality of life. Of importance to their pain management is older people's interaction with health professionals that, if unsatisfactory, may impair the outcome.AIMS: To add to the limited research specific to older people living with chronic pain in the community, we explored how they perceive their experiences of interacting with health professionals, seeking factors that might optimise these interactions.METHODS: Purposive sampling was used to recruit men and women >65 years with self-reported musculoskeletal chronic pain. Qualitative individual interviews and one group interview were undertaken with 23 participants. Data were transcribed verbatim and underwent Framework Analysis.RESULTS: Three themes were identified. Seeking help illustrates issues around why older people in the community may or may not seek help for chronic pain, and highlights the potential involvement of social comparison. Importance of diagnosis illustrates the desire for professional validation of their condition and an aversion to vague explanations based on the person's age. Being listened to and being heard illustrates the importance of empathic communication and understanding expectations, with due respect for the person's age.CONCLUSIONS: In common with people of all ages, an effective partnership between an older person in pain and health professionals is essential if pain is to be reported, appropriately assessed and managed, because of the subjective nature of pain and its treatment responses. For older people with pain, perception about their age, by both parties in the partnership, is an additional factor that can unnecessarily interfere with the effectiveness of this partnership. Health professionals should engage with older adults to clarify their expectations about pain and its management, which may be influenced by perceptions about age; and to encourage expression of their concerns, which may also be affected by perceptions about age.",

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N2 - BACKGROUND: Over 50% of community-dwelling older adults experience chronic pain, which threatens their quality of life. Of importance to their pain management is older people's interaction with health professionals that, if unsatisfactory, may impair the outcome.AIMS: To add to the limited research specific to older people living with chronic pain in the community, we explored how they perceive their experiences of interacting with health professionals, seeking factors that might optimise these interactions.METHODS: Purposive sampling was used to recruit men and women >65 years with self-reported musculoskeletal chronic pain. Qualitative individual interviews and one group interview were undertaken with 23 participants. Data were transcribed verbatim and underwent Framework Analysis.RESULTS: Three themes were identified. Seeking help illustrates issues around why older people in the community may or may not seek help for chronic pain, and highlights the potential involvement of social comparison. Importance of diagnosis illustrates the desire for professional validation of their condition and an aversion to vague explanations based on the person's age. Being listened to and being heard illustrates the importance of empathic communication and understanding expectations, with due respect for the person's age.CONCLUSIONS: In common with people of all ages, an effective partnership between an older person in pain and health professionals is essential if pain is to be reported, appropriately assessed and managed, because of the subjective nature of pain and its treatment responses. For older people with pain, perception about their age, by both parties in the partnership, is an additional factor that can unnecessarily interfere with the effectiveness of this partnership. Health professionals should engage with older adults to clarify their expectations about pain and its management, which may be influenced by perceptions about age; and to encourage expression of their concerns, which may also be affected by perceptions about age.

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