Abstract
BackgroundChronic pain is one of the most common health problems for older adults worldwide and is likely to result in lower quality of life. Living in a different culture may also influence chronic pain and quality of life in older adults. The purpose of this study was to explore how multifaceted elements affect chronic pain and quality of life in older Koreans living in Korea and in older Korean–Americans (KAs) living in the USA.MethodsWe conducted a secondary data analysis of data from 270 adults aged 65 years or over (138 Koreans and 132 KAs). We compared the effects of multifaceted elements on pain and quality of life by testing structural equation models (SEMs) for each group, using a maximum likelihood estimation and bootstrapping.ResultsSEMs for both Korean and KAs showed that age and depressive symptoms directly affected quality of life. The number of comorbidities and depressive symptoms had mediating effects on quality of life through chronic pain in both groups. In older Koreans only, perceived financial status directly affected quality of life. In older KAs only, sleep quality indirectly affected quality of life through chronic pain.ConclusionThe data showed that multimorbidity and depressive symptoms play critical roles for explaining chronic pain in older Koreans and KAs and ultimately negatively influence quality of life. Future intervention program to improve quality of life in older adults with chronic pain should consider the different cultural aspects affecting quality of life for Koreans and KAs.
Highlights
Persistent, recurrent chronic pain affects 39–70% of older adults worldwide [1,2,3,4] and negatively impacts their daily lives by causing discomfort, and by limiting their activities, contributing to loneliness and social isola‐ tion
Previous studies have reported an association between acculturation and chronic pain, the results are somewhat sparse by age group; a relatively high level of accultura‐ tion was found among young immigrants [17, 18], and more acculturated immigrants had a higher prevalence of chronic pain [18]
We aimed to explore how multi‐ faceted elements, including biological, psychological, and social aspects, affect chronic pain and quality of life in older adults with who have chronic pain and the same ethnicity, but who are living in different cultures (Fig. 1)
Summary
Persistent, recurrent chronic pain affects 39–70% of older adults worldwide [1,2,3,4] and negatively impacts their daily lives by causing discomfort, and by limiting their activities, contributing to loneliness and social isola‐ tion. Results SEMs for both Korean and KAs showed that age and depressive symptoms directly affected quality of life. Conclusion The data showed that multimorbidity and depressive symptoms play critical roles for explaining chronic pain in older Koreans and KAs and negatively influence quality of life. Future intervention program to improve quality of life in older adults with chronic pain should consider the different cultural aspects affecting quality of life for Koreans and KAs. For this study, we retrieved data from the original study on: age, gender, perceived financial status (very hard to make a living/a little hard to make a living/not hard to make a living at all), the number of comorbidities, and the level of accul‐ turation (for only older KAs) [11]. The Cronbach’s alpha coeffi‐ cients were 0.84 in a previous study [27], and 0.72 for Kore‐ ans, and 0.79 for KAs in this study, respectively
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