Who to Talk to About my Pain? A Brief Qualitative Study on Perception of Pain and its Management in Swiss Nursing Home Residents

Abstract

BackgroundThe prevalence of pain in nursing home (NH) residents is high. Insufficiently treated pain reduces quality of life and often leads to negative health consequences. Pain experience in older people can be influenced by physical, psychosocial, emotional, and spiritual factors. AimsTo inform development of NH pain management interventions, we studied residents’ pain related perceptions and needs. DesignThis was a qualitative descriptive substudy (embedded in ProQuaS, a larger pain project). SettingsThree Swiss NHs. Participants/SubjectsA purposeful sample of eight NH residents with severe pain and no severe cognitive impairment, based on information from the Minimum Data Set. MethodsEight semistructured interviews were conducted between October and December 2016. The audio-recorded interviews were transcribed verbatim and analyzed inductively using thematic analysis. ResultsThree central themes were identified from the interview data: dealing with major life changes, managing pain, and using formal care. The interviews highlighted the multidimensionality of pain experience in NH residents. In complex pain situations, participants perceived that care workers did not respond adequately to their needs. They had learned to cope with their pain using self-developed strategies and direct consultations with their physicians. ConclusionsThe perceived lack of responsiveness may prompt NH residents to bypass care workers with their pain management concerns. This study's findings will inform the development of an educational intervention for NH care workers.