Pain-coping types among older community-dwelling care receivers with chronic pain

Abstract

Objectives

There is a lack of knowledge on coping with pain and sub-group specific pain-coping profiles among older home care receivers with chronic pain. To describe pain-coping strategies, identify subgroups based on cognitive and behavioral pain-coping strategies and pain-related psychological impairment and to compare these groups with regard to socio-demographic, medical, pharmacological and psychological characteristics.

Method

Data of 212 care receivers were examined using the German pain-coping questionnaire (FESV) to determine how they cope with pain. Subgroups were identified using hierarchic agglomerative cluster analysis, using Ward’s algorithm and squared Euclidean distance, and characterized using socio-demographic, medical, pharmacological and psychological parameters. Multinomial logistic regression was used to identify variables associated with the subgroups.

Results

Older care receivers apply cognitive and behavioral strategies to manage pain. Three subgroups were identified: Cluster 1 (25.9%) with good coping competences and little psychological impairment, Cluster 2 (40.1%) with poor coping competences and high psychological impairment, and Cluster 3 (34%) with good coping competences and high psychological impairment. Significant differences between the clusters were observed for age, pain intensity, pain-related interference, daily activities, depression and resilience. Logistic regression demonstrated that belonging to Cluster 2 was associated with the number of pain-reducing medications, depression and resilience. Belonging to Cluster 3 was significantly linked to daily activities, the number of pain medications, depression and the level of care required.

Conclusion

Differentiating between pain-coping profiles in the group of older care receivers with chronic pain necessitates target group-specific pain-oriented psychotherapeutic interventions, which can result in improved pain management.

Keywords:

• Older care receivers
• chronic pain
• coping with pain
• cluster analysis
• community-dwelling

Acknowledgements

The authors thank health insurance company AOK’s scientific institute (WIdO) for making the German Drug Index available, and to the Helmholtz Zentrum München GmbH for access to the IDOM database.

Disclosure of statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data underlying the results in this manuscript archived at the Institute of Medical Sociology and Rehabilitation Science, Charité – Universitätsmedizin Berlin. They are accessible to all interested researchers on site. For requests, please contact [email protected].

Additional information

Funding

This work was supported by the German National Association of Statutory Health Insurance Funds (GKV-27.03.2017). The Association had no influence on design, methodology, data collection, analysis or preparation of this manuscript.