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

Background: The 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. Aims: To inform development of NH pain management interventions, we studied residents' pain related perceptions and needs. Design: This was a qualitative descriptive substudy (embedded in ProQuaS, a larger pain project). Settings: Three Swiss NHs. Participants/Subjects: A purposeful sample of eight NH residents with severe pain and no severe cognitive impairment, based on information from the Minimum Data Set. Methods: Eight semistructured interviews were conducted between October and December 2016. The audio-recorded interviews were transcribed verbatim and analyzed inductively using thematic analysis. Results: Three 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. Conclusions: The 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. (C) 2019 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.