"2007 Hocking, Sarah L"
Hocking, Sarah Understanding Factors That Influence Quality of Life in Young Adults with Chronic Pain Faculty Mentor: Jane Lassetter, College of Nursing Chronic pain is a prevalent condition among adults of all ages. It has been estimated that between a quarter and a third of older adults experience chronic pain (Donald & Foy, 2004). The chronic pain experience of older adults has been the subject of much research (Schofield, Ryan, & Clarke, 2006; Hopman-Rock, Kraaimaat, & Billsma, 1997). Less research exists on the chronic pain experience of young adults with chronic pain, although young adults represent a significant number of chronic pain sufferers. It has been estimated that more than half of the patients presenting for chronic pain treatment at a large Midwestern university hospital pain center during a seven-year period were less than fifty years of age (Baker & Green, 2005). Chronic pain is associated with feelings of diminished power, depression, and disability (Siedlecki, 2006). For this reason, it is important to understand factors that can promote optimal quality of life with chronic pain. The goal of my research was to better understand the chronic pain experience of adults ages 20-45 by investigating factors that influence quality of life. My hypothesis was that pain control, continuity of activities, family support, and spirituality significantly affected the quality of life of young adults with chronic pain. To evaluate the influence of these factors on quality of life, I interviewed seven adults ages 20- 45 from July to October 2007 about their experiences living with chronic pain. The target number of participants was ten to fifteen, but I encountered unanticipated difficulty recruiting study participants. Many institutions denied permission to post flyers recruiting subjects on their announcement boards. After much inquiring, I was able to post recruiting flyers at only four locations. This made it difficult to obtain the desired number of participants. I conducted interviews with the seven participants in locations of their choice. A semi-structured interview guide was used for the interviews. After the interview, participants completed eighteen-item questionnaires which asked for demographic information and several quality of life ratings. After the recorded interviews were completed, I transcribed the tapes verbatim and analyzed the data. For data analysis, I coded sections of the interviews by topic and identified themes from participants’ experiences. I then organized the data according to theme and analyzed the significance of the data. The findings of this study are consistent with the hypothesis that pain control, continuity of activities, family support, and spirituality influence quality of life. Participants described effective pain control as increasing quality of life. Pain control methods used by participants included positioning, exercise, heat and cold, medication, mental/distraction techniques, chiropractic, diet and nutrition, electrical stimulation, and physical therapy. The presence of uncontrolled pain decreased participants’ quality of life. Continuity of activities referred to the ability of participants to continue the same activities after the onset of chronic pain that they engaged in before the onset of chronic pain. All participants experienced some functional limitations associated with chronic pain such as decreased tolerance for physical activity or decreased ability to perform normal activities of daily living. However, inability to sleep or work negatively influenced quality of life the most. Accepting the limitations associated with chronic pain increased quality of life, while failing to accept these limitations caused emotional and physical distress. Some participants described their chronic pain as a motivation to achieve as they would have without it. Family support was shown to increase quality of life for all participants. Supportive behaviors included providing emotional support, physical assistance, pain control, and motivation; accepting limitations; and believing claims of pain. Non-supportive behaviors identified by participants included setting unrealistic expectations, failing to communicate openly, and denying the existence of pain. Spirituality increased quality of life for most participants, but decreased it for some. Sources of spiritual strength included the belief that pain would be temporary, not viewing chronic pain as a punishment, reliance on God’s strength, spiritual practices such as prayer and scripture reading, and social support from religious congregations. Spiritual obstacles for participants were lack of support and understanding from other congregation members and the belief that a lack of faith contributed to their chronic pain. This study had several limitations, including small sample size, demographic and religious homogeneity of participants, and built-in biases of the semi-structured interview guide. However, I think that this research has important implications for young adults with chronic pain and the families and healthcare providers who interact with them. Conducting this research was an invaluable experience for me. Not only has it enabled me to graduate with University Honors, but it has enriched my educational experience and provided me with a foundation for future graduate work. I will graduate in a few months as a nurse, and I plan to use my findings as I work with individuals of all ages who suffer with chronic pain. References Baker, T. A., & Green, C. R. (2005). Intrarace differences among Black and White Americans presenting for chronic pain management: The influence of age, physical health, and psychosocial factors. Pain Medicine, 6(1), 29-38. Donald, I., & Foy, C. (2004). A longitudinal study of joint pain in older people. Rheumatology, 43(10), 1256-1260. Hopman-Rock, M., Kraaimaat, F. & Billsma, J. (1997). QOL in elderly subjects with pain in the hip or knee. QOL Research, 6(1), 67-76. Schofield, P., Ryan, T., & Clarke, A. (2006). The Experiences of older adults in pain: A literature review. Journal of Community Nursing, 20(11), 4-8. Siedlecki, S. (2006). Predictors of self-rated health in patients with chronic nonmalignant pain. Pain Management Nursing, 7(3), 109-116.