A goal attainment pain management program for older adults with arthritis.

The purpose of this study was to test a pain management intervention that integrates goal setting with older adults (age > or =65) living independently in residential settings. This preliminary testing of the Goal Attainment Pain Management Program (GAPMAP) included a sample of 17 adults (mean age 79.29 years) with self-reported pain related to arthritis. Specific study aims were to: 1) explore the use of individual goal setting; 2) determine participants' levels of goal attainment; 3) determine whether changes occurred in the pain management methods used and found to be helpful by GAPMAP participants; and 4) determine whether changes occurred in selected pain-related variables (i.e., experience of living with persistent pain, the expected outcomes of pain management, pain management barriers, and global ratings of perceived pain intensity and success of pain management). Because of the small sample size, both parametric (t test) and nonparametric (Wilcoxon signed rank test) analyses were used to examine differences from pretest to posttest. Results showed that older individuals could successfully participate in setting and attaining individual goals. Thirteen of the 17 participants (76%) met their goals at the expected level or above. Two management methods (exercise and using a heated pool, tub, or shower) were used significantly more often after the intervention, and two methods (exercise and distraction) were identified as significantly more helpful. Two pain-related variables (experience of living with persistent pain and expected outcomes of pain management) revealed significant change, and all of those tested showed overall improvement.

A bone health intervention for older adults living in residential settings.

Osteoporosis, a major health problem that increases with age, may lead to fractures and loss of independence. This study focused on testing a bone health intervention aimed at assisting older adults living independently in residential settings to maintain healthy bones with the long-term goals of fracture prevention and maintenance of independent function. Forty-seven participants (M (age) = 79.36 years) completed six 1-hour educational sessions. Pre-intervention testing of osteoporosis knowledge and healthy bone behaviors was followed by posttests at 1 week, 6 weeks, and 7(1/2) months. Findings revealed significant increases in knowledge and behaviors from baseline to 9(1/2) months, although a slight decline during the last 6 months when there was no reinforcement of learning suggests the need for periodic follow-up.

Barriers to managing chronic pain of older adults with arthritis.

PURPOSE: To explore barriers to pain management experienced by older adults with arthritis, identify themes, and develop a theoretical model of relationships among the themes. DESIGN AND METHODS: Focus groups were used to collect data with 57 older-adult participants who had self-reported arthritis. Coding techniques consistent with grounded theory methodology were used for data analysis. FINDINGS: Nine themes were identified to describe barriers to chronic pain management experienced by older people with arthritis. The resulting model shows personal decision-making regarding the use of pain management methods. CONCLUSIONS: Findings provide direction for enhancing independent older people's ability to manage chronic pain. The nine categories of barriers show direction for education of both clients and health care providers, as well as for planning other types of needed support. The theoretical model shows the complexity of barriers experienced by older adults with arthritis.