The objective of this literature review is to gain insight into the efficacy of nonpharmacological interventions in chronic pain management in community-dwelling older adults. An extensive search of pertinent databases was performed to identify reports of studies of nonpharmacological (physical and psychosocial) pain interventions. The review identifies intervention studies that used randomized controlled trials (RCTs) and summarizes existing evidence of effectiveness of nonpharmacological interventions. A literature search yielded 28 RCT intervention studies (18 for physical interventions and 10 for psychosocial interventions) that met inclusion criteria and are included in this review. Twenty-one studies (75%) identified in this review demonstrated statistically significant differences (P < .05) in pain scores between nonpharmacological interventions and no intervention or sham interventions; the intervention groups showed lower pain intensity. More research is needed to determine the best format, intensity, duration, and content of such treatments, as well as their efficacy in the older adult population. Methodological limitations are identified in many of the studies, such as low statistical power due to sample size and imprecise measurement, lack of reliable sham controls, and inadequate blinding. Future intervention studies of nonpharmacological pain therapies may require larger sample sizes, control for comorbidities, and long-term follow-up.
"Patient age is also an important consideration in examining responses to interventions for pain. Older adults have increased risks of various ailments related to pain, including arthritis and osteoporosis, but may have poor tolerance to medications for these conditions.86 Further, age may alter psychological reactions to pain; the emotional aspects of pain are more strongly correlated with pain catastrophizing in younger adults than older adults while sensory aspects of pain appear more strongly related to pain catastrophizing in older adults.87 "
[Show abstract][Hide abstract] ABSTRACT: Pain is a complex stressor that presents a significant challenge to most aspects of functioning and contributes to substantial physical, psychological, occupational, and financial cost, particularly in its chronic form. As medical intervention frequently cannot resolve pain completely, there is a need for management approaches to chronic pain, including psychological intervention. Psychotherapy for chronic pain primarily targets improvements in physical, emotional, social, and occupational functioning rather than focusing on resolution of pain itself. However, psychological therapies for chronic pain differ in their scope, duration, and goals, and thus show distinct patterns of treatment efficacy. These therapies fall into four categories: operant-behavioral therapy, cognitive-behavioral therapy, mindfulness-based therapy, and acceptance and commitment therapy. The current article explores the theoretical distinctiveness, therapeutic targets, and effectiveness of these approaches as well as mechanisms and individual differences that factor into treatment response and pain-related dysfunction and distress. Implications for future research, dissemination of treatment, and the integration of psychological principles with other treatment modalities are also discussed.
Psychology Research and Behavior Management 04/2014; 7:115-124. DOI:10.2147/PRBM.S44762
[Show abstract][Hide abstract] ABSTRACT: Background:
The 'Healthy Habits Program' is a 6-month community-based program, which offers exercise facilities, training and weekly health education group to underserved elderly Chinese Americans with chronic medical diseases in their native languages. This pilot study evaluates the acceptability and the health effects of the 'Healthy Habits Program'.
Ninety-nine subjects participated in the 'Healthy Habits Program' in 2011. Before and after the program, the participants were assessed in their physical and mental health using various fitness tests as well as measures of disability and psychological functioning.
Participants provided overwhelmingly positive feedback on the program, which was associated with significant improvements in physical and mental health including a significant decrease in body mass index (BMI), blood pressure and increase in stamina. The participants reported lower mean scores on the Patient Health Questionnaire-9 item Scale (PHQ-9), indicating improved psychological well-being.
These promising pilot study results from this lifestyle intervention program for elderly Chinese American immigrants with chronic diseases inform the design of a more definitive trial using a randomized design and larger sample size.
Journal of Public Health 04/2013; 36(1). DOI:10.1093/pubmed/fdt037 · 2.04 Impact Factor
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