Factors associated with quality of life of older adults with chronic pain

Cross-sectional study conducted with 239 older adults in outpatient care in the state of Goiás, Brazil. The World Health Organization Quality of Life–Old (WHOQOL-OLD) instrument contains six domains and was applied to assess quality of life. Simple and multiple linear regressions were used in the statistical analysis.

Results:

The factors associated with Sensory Abilities were age (β = - 0.52), time spent together (β = - 14.35; - 17.86; - 15.57), and pain intensity (β = - 1, 70). Autonomy was associated with depression (β = - 5.99) and chest pain (β = - 6.17). Social participation related to schooling (β = - 0.64), diabetes mellitus (β = - 8.15), depression (β = - 14.53), pain intensity (β = - 1.43), and lower limb pain (β = - 5.94). Past, present and future activities related to depression (β = - 6.94). Death and dying related to hypertension (β = - 8.40), while Intimacy to depression (β = - 5.99) and headache/face pain (β = - 3.19).

Conclusion:

The time experiencing chronic pain and the location of this experience, as well as depression, diabetes and systemic arterial hypertension were factors that had greater influence on the older adult’s Quality of Life domains.

Descriptors:
Chronic Pain; Quality of Life; Aged; Health Services for the Aged; Geriatric Nursing

Variable	n (%)	Median (IQR) Min-Max
Age (years)		67 (62-72): 60-87
Age group (years)
60-69	159 (66.5)
70-79	72 (30.1)
≥ 80	8 (3.5)
Gender
Male	71(29.7)
Female	168 (70.3)
Marital status
With spouse	117 (49.0)
No spouse	122 (51.0)
Years of schooling (n = 237)		5 (2-9): 0-16
< 8	172 (72.5)
≥ 8	65 (27.5)
Income (R$)		1760.0 (932.0-2.342.0): 50.0-7.040.0
Self-reported comorbidities^* * Multiple choice
Osteoarticular diseases	202 (84.5)
Systemic arterial hypertension	137 (57.3)
Diabetes mellitus	50 (20.9)
Depression	40 (16.7)
Fibromyalgia	28 (11.7)
Cancer	11 (4.6)
Time experiencing pain (years)
6 months-1 year	15 (6.3)
1 (-5; 2.45)	68 (28.5)
5 (-10; 2.45)	42 (17.6)
> 10 years	114 (47.6)
Pain intensity (numeric)		Média (DP). Min-Max
		5.4: (2.2).0-10.0
Pain intensity according to categories
Mild (1-4)	38 (15.9)
Moderated (5-6)	126 (52.7)
Strong (7-9)	25 (10.5)
Worst possible pain (10)	50 (20.9)
Pain location^* * Multiple choice
Lower limbs	195 (81.6)
Low back	137 (57.3)
Shoulders/upper limbs	126 (52.7)
Sacrum/coccyx/anus/pelvis	83 (34.7)
Neck/cervical	70 (29.3)
Chest	60 (25.1)
Joints	35 (14.6)
Head/face	28 (11.7)
Abdominal	28 (11.7)
Whole body	10 (4.2)

WHOQOL-OLD domains	Mean (SD)
Sensory abilities	66.6 (23.3)
Autonomy	61.8 (17.8)
Past, present and future activities	65.8 (17)
Social Participation	63.5 (18.4)
Death and dying	69.1 (25.8)
Intimacy	71.9 (17.5)
Total QL	66.5 (12)

Domains and variables	β (95%CI )	p value
Sensory abilities
Age (years)	- 0.52 (- 1.01;0.03)	0.039
Time experiencing pain
6 months-1 year^®
1-5 years	- 14.53 (- 25.41; - 3.64)	0.009
5-10 years	- 17.86 (- 29.64; - 6.08)	0.003
> 10 years	- 15.47 (- 25.74; - 5.20)	0.003
Pain intensity	- 1.70 (- 2.99; - 0.41)	0.010
Autonomy^† † Multiple regression model adjusted for age, gender, schooling, marital status, time experiencing pain, religion, hypertension, diabetes mellitus, pain intensity, depression, headache/face pain, neck/cervical pain, chest pain, abdominal pain, low back pain and whole body pain. Parameters: F (p-value): 2.25 (< 0.003); R2: 0.164; FIV: 2.02. K-S test for normality of residues: p = 0.174; Breusch- Pagan/Cook-Weisberg test: p = 0.381
Depression	- 5.99 (- 12.07; - 0.08)	0.047
Chest pain	- 6.17 (- 11.69; - 0.66)	0.029
Past, present and future activities^‡ ‡ Multiple regression model adjusted for age, gender, schooling, income, diabetes mellitus, fibromyalgia, depression, other diseases and joint pain. Parameters: F (p-value): 2.57 (< 0.008); R2: 0.092; FIV: 1.08. K-S test for normality of residues: p = 0.189; Breusch-Pagan/Cook-Weisberg test: p = 0.512
Depression	- 6.94 (- 12.75; - 1.13)	0.019
Social participation^§ § Multiple regression model adjusted for age, gender, schooling, marital status, time experiencing pain, diabetes mellitus, fibromyalgia, depression, other diseases, pain intensity, headache/ face pain, neck/cervical pain, lower limb pain and whole body pain. Parameters: F (p-value): 4.01 (< 0.001); R2: 0.224; FIV: 1.72. K-S test for normality of residues: p = 0.132; Breusch-Pagan/ Cook-Weisberg test: p = 0.381
Schooling	- 0.64 (- 1.19; 0.09)	0.023
Diabetes mellitus	- 8.15 (- 13.56; - 2.74)	0.003
Depression	- 11.53 (- 17.56; - 5.49)	< 0.001
Pain intensity	- 1.43 (- 2.49; - 0.38)	0.008
Lower limb pain	- 5.94 (- 11.71; - 0.16)	0.044
Death and dying^\|\| \|\| Multiple regression model adjusted for age, gender, time experiencing pain, hypertension, depression, headache/face pain, neck/cervical pain and upper limb pain. Parameters: F (p-value): 2.33 (< 0.012); R2: 0.093; FIV: 1.93. K-S test for normality of residues: p = 0.200; Breusch-Pagan/ Cook-Weisberg test: p = 0.351
Systemic arterial hypertension	- 8.40 (- 14.54; - 2.26)	0.008
Intimacy^¶ ¶ Multiple regression model adjusted for age, gender, religion, hypertension, fibromyalgia, depression, other diseases, headache/face pain, chest pain, low back pain and whole body pain. Parameters: F (p-value): 2.66 (< 0.002); R2: 0.133; FIV: 1.61. K-S test for normality of residues: p = 0.102; Breusch-Pagan/Cook-Weisberg test: p = 0.181
Depression	- 5.99 (- 11.88; - 0.10)	0.047
Headache/face pain	- 3.19 (- 15.98; - 0.96)	0.027

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[1] Corresponding author: Maressa Gonçalves da Paz E-mail: maressagoncalves184@gmail.com