Friendship in Later Life: How Friends Are Significant Resources in Older Persons' Communication about Chronic Pain.

BACKGROUND: This article focuses on how older persons perceive their friends' role in their daily experience of chronic pain. It reports part of the results of a study in which we interviewed 49 participants, aged 75 and older, about the way they communicate about chronic pain within their social network. METHODOLOGY: Using discourse and content analysis, we first examine older persons' definition of friendship, and then identify the various dimensions of friendship that are engaged in the communication about chronic pain. RESULTS: Participants define close friends as people with whom they share intimacy and social proximity (same gender, age and experience of pain). These dimensions allow older persons to talk freely about their pain without the fear of being judged or rejected, particularly when it is related to a dynamic of reciprocity. CONCLUSIONS: This article shows that the contribution of friends to the everyday life of older persons with chronic pain is mainly that of providing emotional support.

Talking about chronic pain in family settings: a glimpse of older persons' everyday realities.

BACKGROUND: The expression of chronic pain remains a delicate matter for those older persons who suffer from this condition. If many studies highlight the difficulties of putting pain into words, scarce are those that take into account how given social networks can facilitate or prevent its expression. Based on a qualitative study that explores the communication about chronic pain in older persons' social network, this article reports on this key issue of talking about health in later life within family settings and provides clinicians with information about the way older persons with chronic conditions perceive their everyday realities and social relations. METHODS: A multidisciplinary research team (medicine, linguistics and psychology) interviewed 49 persons with chronic pain, all from the French-speaking part of Switzerland, aged 75 and older, without any major cognitive or auditory impairments. After transcription, the interviews were analyzed by combining content and discourse analysis with social network theories. RESULTS: Communication about chronic pain depends significantly on the position of the interlocutors within the family structure, with a preference for direct relatives or individuals with similar difficulties. In social networks, the ability to communicate about chronic pain is both a resource (by allowing older persons to get help or by strengthening interpersonal relations) and a challenge (by threatening their autonomy, social relations or self-esteem). CONCLUSIONS: The study shows the predominance of the nuclear family (partner, children) in communication relating specifically to the everyday management of chronic pain. This state of affairs is, nevertheless, balanced by issues of (loss of) autonomy. These findings, in line with current trends in geriatrics, could benefit future reflections on the scope and limits of including relatives in the care of older patients with chronic conditions.

Ethical issues in public health communication: Practical suggestions from a qualitative study on campaigns about organ donation in Switzerland.

OBJECTIVES: In Switzerland, in spite of a positive attitude towards organ donation, the population seems to overlook the public health messages about it. Based on a qualitative study on campaigns about organ donation, the article aims to give practical suggestions to prevent undesirable effects in public health communication. METHODS: The study provides a linguistic analysis of the messages about organ donation produced by the Swiss Federal Office of Public Health. Such a method enables us to understand who communicates what, to whom, how and what for, and gives us empirical data to discuss ethical concerns in relation to the effects of public health messages. RESULTS: The analysis shows that the messages, apart from those relying on the expertise of healthcare professionals, are based on the representation of lay persons. The latter strategy generates the depiction of imagined communities. CONCLUSIONS: Beyond the usual concerns relating to organ donation (e.g., consent, altruism), the analysis of FOPH messages indicates that ethical issues in public health communication are grounded on three relational dimensions (intersubjectivity, cooperation and equity). PRACTICE IMPLICATIONS: A procedure assessing the ethical concerns of public health communication in terms of social identities and relational consequences could identify and prevent problems relating to the undesirable effects of messages. AVAILABILITY OF DATA AND MATERIALS: The datasets used and analysed during the current study are available from the corresponding author upon reasonable request.

Communication About Chronic Pain in Older Persons' Social Networks: Study Protocol of a Qualitative Approach.

A lack of social relations appears to impact on health and life expectancy among the older persons. The quality and diversity of social relations are correlated with good health and well-being in later life. Chronic pain is a crucial issue in aging population. Effective communication between the older persons with chronic pain, their relatives and the actors of the healthcare system facilitates the management of this condition. Studies on communication in later life generally do not consider the older persons' social network as a whole, focusing only a specific segment (e.g., family or medical staff). This lack of scientific data prevents the actors of the healthcare system from offering solutions to bridge clinically relevant communication gaps. As a consequence, our study has three objectives: (1) to identify how the older persons perceive communication about chronic pain with their social network; (2) to identify their unmet communication needs; (3) to develop recommendations that improve communication about chronic pain in later life. The study will be divided into two phases. The first phase will meet objectives 1 and 2. It will involve individual interviews with about 50 people over 75 years old suffering from chronic pain and without major cognitive or auditory troubles. In this phase, we will apply a multi-layered analysis. We will map the older persons' personal network and identify their communication practices and needs, by combining content and discourse analysis with social network theories. The second phase of the study will aim at recommendations based on the results of the first phase (objective 3). It will require focus groups with different sets of stakeholders (older persons, relative caregivers, health professionals, decision-makers). In the second phase, we will use content analysis to pinpoint the concerns and suggestions for action. The results will be disseminated on three levels: (1) to the scientific world (specialists in the field of health and aging and health communication); (2) to health practitioners working with older persons; (3) to society at large, with a focus on institutions and groups directly concerned by the issue.

[An interdisciplinary approach of the organ donation decision: the Lausanne's experience]. / Approche interdisciplinaire de la decision de don d'organes: l'experience lausannoise.

Since 2007, the Interdisciplinary Ethics Platform (Ethos) of the University of Lausanne is leading an interdisciplinary reflection on the organ donation decision. On this basis, the project "Organ transplantation between the rhetoric of the gift and a biomedical view of the body" studies the logics at stake in the organ donation decision-making process. Results highlight many tensions within practices and public discourses in the field of organ donation and transplantation and suggest lines of inquiry for future adjustments.