Experiencing Pain Alone and in the Presence of Others: A Study of Older Adults

Date
2016-09
Authors
Gallant, Natasha Louise
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Faculty of Graduate Studies and Research, University of Regina
Abstract

Pain, defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (Merskey & Bogduk, 1994, p. 210), is a central clinical issue among older persons. Many older adults undergo several painful medical and surgical procedures, yet it remains uncertain whether social support influences an older person’s experience and expression of pain when undergoing such procedures. This study, therefore, was aimed to investigate the role of social support in pain experiences and expressions among community-dwelling older adults. The study was carried out within the framework of the communications model of pain, which emphasizes the role of social factors in the experience and expression of pain. A withinsubjects research design involving three social support conditions was employed during a laboratory pain induction task: in the first condition, no social support person was present; in the second, a stranger (i.e., the experimenter) was present; in the third, an immediate adult family member (e.g., spouse, offspring) was present. Subjective and objective indices of pain were collected, including pain threshold and tolerance, selfreported pain ratings, and non-verbal facial expression scores. In the condition where participants were in the presence of a stranger, participants reported the pain to be significantly less unpleasant compared to when they were alone. Non-verbal pain expressions were significantly more intense when participants were with their family member. When they were with a family member, participants expressed significantly more happiness compared to when they were alone. As well, participants expressed significantly less fear when they were alone compared to when they were with a stranger. Compared to males, females were shown to have lower pain tolerance, more intense nonverbal pain expressions, more expressed neutral states, more expressed happiness, and less expressed anger. These sex differences were not found to significantly interact with social support conditions for any of the dependent variables. The impact of other demographic and relationship characteristics between the older person and their chosen immediate family member on these pain indices was also explored. Findings from the exploratory analyses showed that the perceived importance of the family member to the participant and the instrumental support provided by the family member predicted a significant amount of variance in pain threshold. Unique contributions of this investigation comprise of the focus on older adults and the examination of facial expressions. It would be of interest to pursue research investigating social influences in larger, more representative samples as well as specific populations of interest such as older adults affected by dementia. Investigations of the role of social support in clinical settings would help determine the generalizability of the findings from this experimental investigation. Overall, these results suggest that social parameters are important contributors to the communications model of pain and that they should be taken into consideration when assessing and managing pain among older adults.

Description
A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Arts in Clinical Psychology, University of Regina. x, 135 p.
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