(264) Managing pain: the experiences of community dwelling Black elders

Abstract

Black elders represent a disparate population that has been shown to consistently have unmet pain needs. These adults are less likely to report pain concerns to providers and generally receive poorer quality of care with less access to services as compared to White elders. To better understand the pain management experiences and concerns of Black elders, an ethnographic study was completed within an urban, low-income, elder housing facility. 106 participants completed a questionnaire comprised of a demographic tool, the PROMIS Global Health Scale (PROMIS), the Brief Pain Inventory (BPI), and the Psychological Stress Measure (PSM-9). Additionally, participant observation, informal interviews, and 20 formal recorded interviews with individuals identified as having pain were completed. Results indicate that 86 percent of the sample had an average pain rating of 7 on a 0 to 10 scale with 5 pain sites. Pain interference, was about 4, on a 0 to 10 scale. Specific areas of interference included general activity (5.59), walking (5.73) and normal work (5.7). Participants preferred non-pharmacological treatments and topical analgesics. Preferences were related to concerns with side effects, fears of addiction, and provider mistrust. Prescription medications most commonly used for pain included hydrocodone with acetaminophen, acetaminophen with codeine, tramadol, and ibuprofen. Seventeen percent of the population took no painmedications. Global physical health scores for patients with pain were 36, while Global mental health scores were about 44-respectively 2 and 0.5 standard deviations lower than US norms. Mild to moderate stress was reported by the PSM- 9. Adaptive coping strategies used by participants to manage pain included: remaining positive, exercise/ remaining active, being engaged in the community, prayer/meditation, and maintaining positive support systems. Poverty was added stressor to managing pain. Pain management may be improved for Black elders by proving balanced health information and increasing patient follow-up post-office visit.