Not So Golden After All

The Complexities of Chronic Low Back Pain in Older Adulthood

Meredith L. Stensland, PhD, LMSW; Sara Sanders, PhD, MSW

Disclosures

Gerontologist. 2018;58(5):923-931. 

In This Article

Research Design and Methods

This study is part of a larger study conducted in a Midwestern college town which examined the experience of CLBP among older pain clinic patients, and procedures pertaining to recruitment, data collection, and data analysis are thoroughly detailed elsewhere (see Stensland & Sanders, Under review). Briefly, the aim of this investigation was to develop an understanding of what living with CLBP is like for older adults. To examine this lived experience, researchers employed van Manen's (1990, 2014) Phenomenology of Practice method. A total of 21 participants took part in the study, all of which whom met the sample inclusion criteria: 65 years of age or older, current patient at a pain clinic, self-reported duration of CLBP for at least 3 months, CLBP is primary pain complaint, community-dwelling, cognitively intact, and English-speaking.

Recruitment occurred over a 3-month period during which the first author recruited participants in three ways: (a) flyer recruitment at five pain clinics (8 participants); (b) in-person recruitment at two of the pain clinics (7 participants); and (c) university mass e-mail system (6 participants). Participants were given an informational study flyer while at a pain clinic appointment and either instructed to contact the researcher if interested or were invited to speak in-person with the researcher when the researcher was on-site. The mass e-mail was sent to all university retires, faculty, and staff and specified individuals must be a pain clinic patient with CLBP; the other eligibility criteria were later verified.

One-on-one, semistructured in-depth interviews were the primary form of data collection, which were audio-recorded and transcribed verbatim. All interviews were conducted in-person and by the first author, who is a Caucasian female and was 26 years of age at the time of data collection. All but three interviews were conducted in-home. Interviews ranged in duration from 30 to 109 min, with a median length of 61 min. Two participants completed two interviews, because they either appeared to be fatiguing (e.g., less focused answering of questions) or were still fully sharing at the time the interview concluded. An interview guide was used to prevent completion of unfocused interviewing (see Supplementary Appendix), though the questions were open-ended and flexible, allowing for new ideas to be discussed depending on what participants shared. Excluding the subtheme "hurting slowly, aging quickly" in which the experience of time was specifically inquired about, participants were not explicitly questioned about any of the other subthemes. The first author line-by-line coded all transcripts to conduct thematic analysis and identify meaning units in the data. During this process, the authors met frequently to jointly review the coding, discuss the meaning of the themes, and achieve a consensus in regard to final thematic structure. Seven essential themes ultimately emerged as capturing the essential structure of the CLBP experience among participants, of which one, "Not so golden after all," is presented herein. This study received university IRB approval.

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