Chronic Pain Self-Management for the Elderly

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Chronic musculoskeletal pain is a common problem in the elderly, and is often associated with significant physical disability and psychosocial problems. As the population of older adults grows, the personal and societal burden of chronic pain will escalate. The purpose of this study is to evaluate the efficacy of a self-management group intervention in decreasing pain and improving functioning among elderly retirement community residents with chronic musculoskeletal pain. Although self- management approaches have been shown to be effective for several chronic pain conditions, little prior research has focused on older adults, particularly those in the mid-old (75-84 years) and old-old (over 85 years) subgroups. A randomized clinical trial will evaluate the efficacy of this intervention, as compared with an educational book intervention, in improving physical and social functioning, and decreasing pain intensity and depression, short-term and at one year follow-up. In addition, this research will test predictions based on cognitive-behavioral theory concerning the relationships of changes in beliefs and coping strategies to changes in functioning, depression, and pain intensity. The specific aims are: (1) evaluate the efficacy of a chronic pain self-management group (SMG) intervention, as compared with an educational book control condition (BOOK), in decreasing pain and depression and improving functioning among elders living in retirement communities; and (2) determine the extent to which SMG participation is associated with changes in specific pain-related beliefs and coping strategies, and the extent to which changes in these process variables are associated with changes in outcomes (physical and social functioning, pain intensity, and depression). The study will be conducted in a novel treatment setting - the retirement apartments and communities in which study participants live. These treatment venues capitalize on the social and healthcare resources already available to residents, and offers unique opportunities for widespread adoption of the intervention subsequent to the completion of the study.