Osteoarthritic pain in knees among Chinese elders: Establishing a pain model and testing the feasibility of an innovative and interdisciplinary intervention protocol

Project: National Science and Technology CouncilNational Science and Technology Council Academic Grants

Project Details

Abstract

Osteoarthritis (OA), a degenerative disease that commonly affects older people, is manifested by pain and disability. Because of its negative impact on functional independence, psychosocial consequences, and quality of life, OA knee pain among the elderly is a significant issue. The major modality for treating OA pain is pain medication. However, pain is an under-treated issue in Taiwanese elders. Many analgesic treatments are limited by high cost, adverse side effects, and the potential for drug-drug interactions, highlighting the importance of exploring non-pharmacological therapies and strategies to relieve OA pain in the elderly. Despite the rich information in the current western literature on managing OA knee pain, two issues remain. First, most OA pain-intervention studies have included other age groups besides elders, making it difficult to estimate the true effectiveness of these interventions on elders. Second, available recommendations for managing OA do not distinguish between hip and knee OA and may lack support from randomized clinical trials. Thus, these recommendations may not be appropriate for developing OA knee pain-intervention protocols. Since OA knee pain is chronic and progressive, studies on elders with chronic pain may provide evidence for developing an OA knee pain intervention protocol in this population. Taken together, evidence on OA pain- and chronic pain management among elders could be used to establish a more comprehensive OA knee pain intervention. To date, few studies could be found on OA-related pain in Chinese elders and none on interdisciplinary pain-intervention protocols for elderly patients with OA pain. Most studies on pain in Chinese elders have borrowed tools or ideas from cancer patients’ pain. However, cancer can affect any age group. Another issue is that misconceptions and negative attitudes about aging are frequent among health care providers and the general public. These negative attitudes are shared by some elders and are enforced by society. As a result, elders may form unique pain beliefs and models to manage their pain. These factors make it inappropriate to develop a randomized controlled trial intervention to relieve pain in this population without more preparation. First, Chinese elders’ beliefs about their OA knee pain must be explored. Second, culturally relevant tools urgently need to be developed to measure Chinese elders’ pain. Finally, a suitable model is needed to guide an OA knee pain-intervention program for Chinese elderly. To fill these gaps in knowledge, the proposed study has the long-term goals of establishing a pain model for Chinese elders and developing an interdisciplinary pain-intervention protocol to relieve their OA knee pain. This proposed 5-year grant will have four stages. In Stage I, we will explore the concept of OA knee pain among Chinese elders by triangulating qualitative data from elders, physicians, nurses, and caregivers. In Stage II, we will establish and validate measures for the meaning of pain, pain beliefs, and self-care strategies to manage OA knee pain among Chinese elders. In Stage III, we will establish a pain model for Chinese elders with OA knee pain. In Stage IV, we will develop and test the feasibility of an interdisciplinary pain-intervention protocol among elderly patients with OA knee pain. The study results will provide preliminary suggestions for intervention protocols for elderly persons with OA knee pain and guidelines for developing intervention programs for elderly persons with other pain in Taiwan.

Project IDs

Project ID:PC10202-0248
External Project ID:NSC100-2314-B182-019-MY3
StatusFinished
Effective start/end date01/08/1331/07/14

Keywords

  • Osteoarthritis
  • pain
  • elder
  • model
  • intervention protocol

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