A socioecological model analysis of chronic pain in an underserved community clinic

Background & Aims

Chronic pain is highly prevalent and disabling for older adults, particularly those from underserved communities. However, there is an absence of research on how contextual (e.g., community/societal) factors interact with pain for these patients. Informed by the socio-ecological model, this study aimed to elucidate the individual, interpersonal, community, and societal factors associated with chronic pain from the perceptions of older adult patients and medical staff in a community clinic.

Methods

In this qualitative study, we conducted focus groups and interviews with medical staff (n=25) and older adult patients with chronic pain (n=18). We transcribed interviews and thematically analyzed data using a hybrid deductive-inductive approach.

Results

At the individual level, we identified three themes: (1) older adults with complex care needs, (2) impact of pain (including on physical, emotional, work, and identity functioning), and (3) coping with pain. At the interpersonal level complex relationships with (1) social supports and (2) medical staff emerged as themes. The need for (1) resources and (2) culturally-informed care was identified at the community level, and socioeconomic status impacting the availability of resources for managing chronic pain emerged for the societal domain.

Conclusions

Findings underscore the intersection of factors contributing to the experience of pain among older adults from underserved communities. Our findings highlight the need to develop and implement treatments that fully address the experience of older adults with chronic pain at the individual, interpersonal, community, and societal levels.

References

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