270338 Pain and Quality of Life: Exploring Factors Contributing to a Paradoxical Relationship

Monday, October 29, 2012

SangNam Ahn, PhD, MPSA , Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis, TN
Matthew Lee Smith, PhD, MPH, CHES , Department of Health Promotion and Behavior, The University of Georgia, College of Public Health, Athens, GA
Kate Lorig, DrPH, RN , Patient Education Research Center, Stanford School of Medicine, Stanford, CA
Phil Ritter, PhD , Stanford Patient Education Center, Stanford University School of Medicine, Palo Alto, CA
Marcia G. Ory, PhD, MPH , Social & Behavioral Health, Texas A&M HSC School of Rural Public Health, College Station, TX
Background. Pain severely affects many older adults, compromising their quality of life (QOL). However, few studies have investigated factors associated with having severe pain but reporting high QOL. This study examines the relationship between pain and QOL, identifying factors associated with paradoxical responses.

Methods. We included 1,165 adults aged 65 years or older who enrolled in the Chronic Disease Self-Management Program nationwide in 2010-2011. The current study compared those who reported severe pain and low QOL with those who reported severe pain but high QOL as well as those who reported no or minimal pain and high QOL. Covariates included demographic, health status, daily functional ability, and behavioral factors. Multinomial logistic regression was used to identify factors associated with reporting high QOL despite severe pain.

Results. Approximately 32% of study participants reported severe pain and low QOL. Another 22% and 31% reported having severe pain but high QOL and having no or minimal pain and high QOL, respectively. Those who were African American (odds ratio [OR]=2.24; confidence interval [CI]=1.03, 3.87), had better perceived health (OR=3.26; CI=2.10, 5.06), and had more physically active days (OR=1.10; CI=1.01, 1.19) were more likely to report having severe pain but high QOL. Inversely, those who reported having more interference with daily activities tended to have severe pain and low QOL (OR=0.76; CI=0.72, 0.81).

Significance of the work. Studying dynamics of pain and QOL can be meaningful for clinicians and researchers to understand successful aging and design better intervention efforts.

Learning Areas:
Chronic disease management and prevention

Learning Objectives:
1. Identify factors that contribute to reports of severe pain but good quality of life among older adults. 2. Explore factors that contribute to reports of no or minimal pain and good quality of life. 3. Identify policy and program implications of having severe pain but good quality of life among older adults.

Keywords: Aging, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have shown my excellence in studying in obesity and chronic disease management publishing around 20 peer-review articles or a book chapter.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.