Help-seeking behavior among community-dwelling adults with chronic pain

Figures & data

Table 1. Individual characteristics of help-seeking and non-help-seeking participants.

Characteristic	Total (n = 696)	Help-seeking (n = 652)		Non-help-seeking (n = 44)		RR (95% CI)	P
	n	n	%	n	%
Gender
Male	352	323	91.8	29	8.2	1.00
Female	342	327	95.6	15	4.4	0.53 (0.29–0.98)	0.04
Employment status
Employed	334	306	91.6	28	8.4	1.00
Retired	260	253	97.3	7	2.7	0.32 (0.14–0.72)	<0.01
Other	102	93	91.2	9	8.8	1.05 (0.51–2.16)	0.89
Annual household income $100 000+	162	147	90.7	15	9.3	1.00
$50 000–$100 000	236	220	93.7	16	6.8	0.73 (0.37–1.44)	0.37
<$50 000	250	238	95.2	12	4.8	0.52 (0.25–1.08)	0.08
Pain self-efficacy
High (40+/60)	502	465	92.6	37	7.4	1.00
Low (<40/60)	157	152	96.8	5	3.2	0.43 (0.17–1.08)	0.07
Family and/or friends encourage pain management
Not at all	176	162	92.0	14	8.0	1.00
A moderate amount or great deal	483	458	94.8	25	5.2	0.65 (0.35–1.22)	0.18
Use of prescription medication^a
No	403	372	92.3	31	7.7	1.00
Yes	207	202	97.6	5	2.4	0.31 (0.12–0.80)	<0.01
Use of over-the-counter medication^a
No	298	286	96.0	12	4.0	1.00
Yes	324	298	92.0	26	8.0	1.99 (1.02–3.88)	0.04
Use of physical therapy and/or exercise
No	550	520	94.5	30	5.5	1.00
Yes	107	98	91.6	9	8.4	1.54 (0.75–3.15)	0.24
Use of chiropractic and/or massage therapy
No	546	515	94.3	31	5.7	1.00
Yes	112	104	92.9	8	7.1	1.26 (0.59–2.66)	0.55
Use of other pain management strategy
No	517	484	93.6	33	6.4	1.00
Yes	139	133	95.7	6	4.3	0.68 (0.29–1.58)	0.37
Use of nothing for pain
No	585	552	94.4	33	5.6	1.00
Yes	73	67	91.8	6	8.2	1.46 (0.63–3.36)	0.38
Satisfaction with ability to manage pain
Completely satisfied or no significant pain	136	128	94.1	8	5.9	1.00
Somewhat or fairly satisfied	455	425	93.4	30	6.6	1.12 (0.53–2.39)	0.77
Completely dissatisfied	89	84	94.4	5	5.6	0.96 (0.32–2.82)	0.93

^aForty-eight responses are missing due to the response being unclear with regards to medication type.

RR = relative risk; CI = confidence interval.

Table 2. Unadjusted and adjusted regression analyses of variables associated with non-help-seeking behavior.^a

Variable	Total	Unadjusted analysis		Adjusted analysis^b
	(n = 696)	OR (95% CI)	P	OR (95% CI)	P
Gender
Male	352	1.00		1.00
Female	342	0.51 (0.27.–0.97)	0.04	0.39 (0.18–0.86)	0.02
Use of over-the-counter medication^c
No	298	1.00		1.00
Yes	324	2.08 (1.03–4.20)	0.04	2.52 (1.14–5.58)	0.02
Comorbid chronic condition(s)
No	288	1.00		1.00
Yes	408	0.27 (0.14–0.53)	<0.01	0.46 (0.22–0.98)	0.04
Treated as equal partner by health care provider in decision making
Not at all	264	1.00		1.00
A moderate amount or great deal	382	0.32 (0.16–0.66)	<0.01	0.40 (0.18–0.93)	0.03
Ranked importance of health care provider to management
Not at all	133	1.00		1.00
A moderate amount or great deal	518	0.24 (0.12–0.48)	<0.01	0.39 (0.18–0.85)	0.02

^aNagelkerke r² = 0.17.

^bEntered into the equation (P < 0.20 in unadjusted analysis) were gender, employment status, annual household income, pain self-efficacy, family/friends encouraging pain management, use of prescription medication, use of over-the-counter medication, pain intensity, SF-36 PCS, SF-36 MCS, pain located in the back, pain located in the legs or feet, comorbid chronic conditions, HCP explained pain management, HCP treated participant as equal partner, HCP listened to concerns, HCP answered questions, HCP explained test results, ranked importance of HCP to pain management, and access to health care services.

^c48 responses are missing due to the response being unclear with regards to medication type.

OR = odds ratio; CI = confidence interval; SF = Short Form; PCS = physical component score; MCS = mental component score; HCP = health care provider.

Table 3. Pain and general health (problem) characteristics of help-seeking and non-help-seeking participants.

Characteristic	Total (n = 696)	Help-seeking (n = 652)		Non-help-seeking (n = 44)		Statistic	P
		Mean	SD	Mean	SD
Pain intensity (NRS)	688	5.0	2.3	4.0	2.2	−2.50	0.01
SF-36 MCS	682	48.7	11.4	51.4	8.4	2.05	0.04
SF-36 PCS	682	42.0	9.8	44.5	9.1	1.62	0.11
	n	n	%	n	%	RR (95% CI)	P
Pain in head, face, or neck
No	492	459	93.3	33	6.7	1.00
Yes	204	193	94.6	11	5.4	0.80 (0.41–1.56)	0.52
Pain in back
No	318	305	95.9	13	4.1	1.00
Yes	378	347	91.8	31	8.2	2.00 (1.07–3.77)	0.03
Pain in arms
No	337	315	93.5	22	6.5	1.00
Yes	359	337	93.9	22	6.1	0.94 (0.53–1.66)	0.83
Pain in hips
No	479	445	92.9	34	7.1	1.00
Yes	217	207	95.4	10	4.6	0.65 (0.33–1.29)	0.22
Pain in knees
No	434	409	94.2	25	5.8	1.00
Yes	262	243	92.7	19	7.3	1.26 (0.71–2.24)	0.43
Pain in legs
No	375	347	92.5	28	7.5	1.00
Yes	321	305	95.0	16	5.0	0.67 (0.37–1.21)	0.18
Pain timing
All the time or daily	335	318	94.9	17	5.1	1.00
Most days of the week	258	239	92.6	19	7.4	1.45 (0.77–2.74)	0.25
Once per week or less	90	83	92.2	7	7.8	1.53 (0.66–3.58)	0.32
Neuropathic characteristics (SLANSS)
No	494	462	93.5	32	6.5	1.00
Yes	171	164	95.9	7	4.1	0.63 (0.28–1.41)	0.26
Comorbid chronic condition(s)
No	288	257	89.2	31	10.8	1.00
Yes	408	395	96.8	13	3.2	0.30 (0.16–0.56)	<0.01
Comorbid depression (PHQ-9)
Unlikely	517	485	93.8	32	6.2	1.00
Suspected	134	128	95.5	6	4.5	0.72 (0.31–1.69)	0.46

NRS = numeric rating scale; SF = Short Form; MCS = mental component score; PCS = physical component score; RR = relative risk; CI = confidence interval; SLANSS = Self-Report Leeds Assessment of Neuropathic Symptoms and Signs Scale; PHQ-9 = Patient Health Questionnaire-9.

Table 4. Health care professional characteristics of help-seeking and non-help-seeking participants.

Characteristic	Total (n = 696)	Help-seeking (n = 652)		Non-help-seeking (n = 44)		RR (95% CI)	P
	n	n	%	n	%
Health care provider explained how to manage pain
Not at all	199	180	90.5	19	9.5	1.00
A moderate amount or great deal	450	432	96.0	18	4.0	0.42 (0.22–0.78)	<0.01
Treated as equal partner by health care provider in decision making
Not at all	264	240	90.9	24	9.1	1.00
A moderate amount or great deal	382	370	96.9	12	3.1	0.35 (0.18–0.68)	<0.01
Health care provider listened to concerns
Not at all	107	97	90.7	10	9.3	1.00
A moderate amount or great deal	544	518	95.2	26	4.8	0.51 (0.25–1.03)	0.06
Health care provider answered questions
Not at all	110	99	90.0	11	10.0	1.00
A moderate amount or great deal	542	517	95.4	25	4.6	0.46 (0.23–0.91)	0.03
Health care provider explained test results
Not at all	114	101	88.6	13	11.4	1.00
A moderate amount or great deal	529	506	95.7	23	4.3	0.38 (0.20–0.73)	<0.01
Ranked importance of health care provider to management
Not at all	133	115	86.5	18	13.5	1.00
A moderate amount or great deal	518	499	96.3	19	3.7	0.27 (0.15–0.50)	<0.01
Annual visit(s) to other health professional
No	332	307	92.5	25	307	1.00
Yes	363	344	94.8	19	344	0.70 (0.39–1.24)	0.22

RR = relative risk; CI = confidence interval.