A qualitative study of older adults seeking appropriate treatment to self-manage their chronic pain in rural North-East Thailand

Abstract

BackgroundMany older adults suffer from chronic pain which decreases their functional capacity and reduces quality of life. Health behaviours and self-care during chronic illness and chronic pain can exert an important influence on health outcomes. The aims of this study were to (a) understand how older adult Thai individuals seek appropriate treatment to self-manage their chronic pain, and (b) to identify factors that contribute to effective pain self-management.MethodsQualitative interviews were conducted with 32 older adults living in villages in north-east Thailand. Observations were also conducted with consenting individuals. Most interviews were audio-recorded and transcripts were coded and analysed using a grounded theory approach.ResultsSix contextual determinants affected the way participants choose to self-manage their chronic pain, including: priority accorded to pain management; information and resource seeking skills; critical appraisal skills; access to pain-related information; access to treatment; and satisfaction and preferences for practitioners. Participants used several strategies to inform and develop their self-management plans: accessing and responding to information, sourcing resources, trial and error, evaluating treatment and evaluating practitioners.ConclusionsAttempts to increase accessibility, affordability and acceptability of pain treatment can promote pain self-management in older Thais. These findings have important implications for health professionals and government organisations seeking to enhance the self-management of pain and quality of life in this population.

Access Barrier in Rural Older Adults’ Use of Pain Management and Palliative Care Services: A Systematic Review

“…The 8 studies included in the systematic review were Choi et al, 13 Duggleby et al, 12 Dumont et al, 25 Hearn & Slack-Smith, 19 Panpanit et al, 18 Schatz et al, 15 Wilson et al, 16 and Zullig et al 17 All the studies were published between 2011 and 2019. Three studies were conducted in Canada, 12,16,20 1 in South Korea, 13 1 in Thailand, 18 1 in Uganda, 15 1 in Australia 19 and 1 in the U.S. 17 Four of the studies used only qualitative method, including interviews 12,19,18 and focus groups. 12,15 Wilson et al 16 used both qualitative interviews and survey data.…”

“…For example, Choi et al 13 reported that, in South Korea, the percentage of areas with public transportation that operates 3 times or fewer per day was 11.9% in 2015, and the percentage of areas with public transportation that operates 6 times or fewer per day was 40.0% in the same year. Panpanit et al 18 mentioned poor availability and access to public transportation as a dilemma associated with isolation for older adults living in villages located in north-east Thailand that were greater than 45 kilometers away from the provincial capitals. Wilson et al 16 identified that traveling was a greater burden in rural areas of Alberta, Canada compared to urban areas that had affordable transportation options like city buses or other public transportation.…”

Older adult’s experience of chronic low back pain and its implications on their daily life: Study protocol of a systematic review of qualitative research

“…Since chronic LBP can disrupt older adults’ life, as well as their family’s life and/or social relationships [ 36 ], it is paramount to look beyond medical treatments for these individuals so that more comprehensive approaches (e.g., the provision of supportive services or spouse participation) can be formulated to address age-related needs. For instance, a qualitative study interviewing a group of older adults with chronic pain living in rural Thailand revealed that these patients were more likely to adopt self-management programs when treatment for pain reduction or related information was more accessible, affordable, and acceptable [ 38 ]. Such information can inform the effective allocation of resources to meet patients’ needs.…”

utcomes of Non-Pharmacological Nursing Interventions’ on Patients with Chronic Pain

“…The treatment group reported that they consumed less analgesics, less antiinflammatory drugs and less muscle-relaxant drugs when compared to the control group. Panpanit et al [5] study verified that Education Programmer that include pain and symptom management strategies as well a healthy lifestyle behaviors and problem-resolution strategies have a positive result on individual's functionality and self-management. The American Pain Society recommends patient education as a fundamental first step to pain control preceding to any type of pharmacological intervention.…”

“…Furthermore, in both types of manipulation an increase of the cervical movement's range of motion was verified (Table 1). 2 -Electro-massage with interferential current [8] 2 -Decreased pain perception [6] 3 -Auditory and Visual stimulation [10] 3 -Decrease usage of drugs [4,10] 4 -Use of woollen undergarments [4] 4 -Functional capacity improvement [8,9] 5 -Auricular Acupressure [7] 5 -Quality of Life improvement [6,8] 6-Follow-up Programmes [6] 6 -Better sleep pattern [10] Coping Strategies 1 -Group-Therapy Sessions [5] 1 -Self-management Improvement [5,6] 2 -Problem-solving strategies [5] 2 -Therapeutic Adherence promotion [5] 3 -Behavioural Cognitive Therapeutic [6] 3-Distress reduction [5] 4 -Therapeutical Dialogue [6] Quality of Life 1 -Group-Sessions Family Participation [5] 1 -Family workload relief [5] 2 -Pain treatment information [5] 3 -Nursing care satisfaction [5] 3 -Pratictioners' Evaluation [5] 4 -Cost-Effective relation (reduction in pharmacological drugs' usage) [4,10] Literacy 1 -Health Education (healthy lifestyles) [5] 1 -Rational utilization of health services [5] The non-pharmacological nursing interventions have been developed from a vision that integrates the individual's biopsychosocial level, empowerment and making patient the main responsible for this process of rehabilitation. It is commonly agreed, that the non-pharmacological interventions only by themselves do not replace the pharmacological ones, but the combination of both brings a wide range of benefits to the treatment of chronic pain.…”