Overcoming the influence of chronic pain on older patients' difficulty with recommended self-management activities

Gerontologist. 2007 Feb;47(1):61-8. doi: 10.1093/geront/47.1.61.


Purpose: Many older patients with common chronic conditions also experience chronic pain. We examined how chronic pain affects patients' difficulty with recommended self-management activities and the potential intervening role of self-efficacy (the level of confidence in one's own ability to perform a specific task).

Design and methods: We obtained data from a cross-sectional nationwide survey of older patients, primarily older men, with chronic health conditions (N = 543). We defined chronic pain as pain present most of the time for 6 months or more during the past year. We assessed ability to follow self-management recommendations by asking respondents to rate their level of difficulty in performing three commonly recommended activities as suggested by their doctor.

Results: More than 60% of survey respondents reported chronic pain. Chronic pain was significantly associated with difficulty exercising regularly (odds ratio [OR] = 1.57, 95% confidence interval [CI] = 1.04-2.37) and taking prescribed medications (OR = 3.08, 95% CI = 1.10-8.59) but not with following a recommended eating plan (OR = 1.16, 95% CI = 0.76-1.76). However, when we took self-efficacy into account, chronic pain was no longer significantly associated with either exercise or taking medications.

Implications: Chronic pain is a prevalent condition among older patients and is associated with greater reported difficulty performing certain essential self-management activities. Self-efficacy, however, plays an important intervening role. Specifically, higher self-efficacy negated or reduced the association between chronic pain and reported difficulty exercising and taking medications. Promoting self-efficacy among older adults with multiple chronic health problems is a promising strategy to improve their ability to follow self-management recommendations.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Chronic Disease
  • Cross-Sectional Studies
  • Female
  • Health Status
  • Humans
  • Male
  • Multivariate Analysis
  • Pain / rehabilitation*
  • Patient Compliance
  • Regression Analysis
  • Self Care*
  • Treatment Refusal*