Anzai Saori, Sato Miyuki, Ikeda Shinpei, Shiba Yoshitaka, Yoshida Hiroto, Haga Hiroshi, Ueki Shouzoh
Institute for Gerontology, J.F. Oberlin University.
Kanagawa Institute of Technology.
Nihon Koshu Eisei Zasshi. 2018;65(2):61-71. doi: 10.11236/jph.65.2_61.
Objectives Musculoskeletal pain impairs vital function and results in a requirement for long-term care. According to studies in other countries, a program that aims at reducing pain through instructions for pain-coping should be implemented. In Japan, a study on pain-coping has recently been initiated; however, the methods of coping with pain that are implemented by community-dwelling elderly individuals have not been evaluated. This study aimed to clarify the methods currently used for coping with musculoskeletal pain and to examine their association with the state of pain among community-dwelling elderly individuals.Methods A survey was performed by sending questionnaires by mail to 2,281 community-dwelling elderly individuals. Responses were obtained from 1,835 people. The survey items consisted of questions about basic attributes and pain. A total of 16 questionnaire items regarding the methods of coping with pain were used for measuring pain-coping that community-dwelling elderly individuals use. The methods of coping with pain were classified into various types by factor analysis. The scores were calculated by type and their association with the state of pain was analyzed using one-way analysis of variance.Results As a result of the factor analysis, methods of coping with pain were classified into five categories: "treatment in hospitals," "daily active coping," "restriction of daily behavior," "self-therapy," and "rest." From one-way analysis of variance for the site of pain, there was a significant difference between the "treatment in hospitals" and "restriction of daily behavior" categories. Among both scores, a higher score was observed in subjects with pain in both the lower back and the knee, compared to those with only pain in the lower back or the knee. Among the number of the sites, there was a significant difference between the "treatment in hospitals," "restriction of daily behavior," and "self-therapy" categories; subjects exhibiting two or more sites of pain showed a higher score than those exhibiting one site of pain. For pain duration, there was a significant difference between the "treatment in hospitals," "restriction of daily behavior," and "self-therapy" categories; subjects who had experienced pain for 5 years or longer had a higher score than those who had experienced pain for less than 6 months.Conclusion We found that five types of methods of coping with pain ("treatment in hospitals," "daily active coping," "restriction of daily behavior," "self-therapy," and "rest") were used by community-dwelling elderly individuals and that "treatment in hospitals" and "restriction of daily behavior" were the most common strategies among elderly individuals with pain.
目的 肌肉骨骼疼痛会损害重要功能，导致需要长期护理。根据其他国家的研究，应实施一项旨在通过疼痛应对指导来减轻疼痛的计划。在日本，最近已启动一项关于疼痛应对的研究；然而，社区居住的老年人所采用的疼痛应对方法尚未得到评估。本研究旨在阐明社区居住的老年人目前用于应对肌肉骨骼疼痛的方法，并研究这些方法与疼痛状态之间的关联。
方法 通过邮件向2281名社区居住的老年人发送问卷进行调查。共收到1835人的回复。调查项目包括关于基本属性和疼痛的问题。总共16个关于疼痛应对方法的问卷项目用于衡量社区居住的老年人所采用的疼痛应对方式。通过因子分析将疼痛应对方法分为不同类型。按类型计算得分，并使用单因素方差分析分析其与疼痛状态的关联。
结果 因子分析的结果显示，疼痛应对方法分为五类：“医院治疗”、“日常积极应对”、“日常行为限制”、“自我治疗”和“休息”。从疼痛部位的单因素方差分析来看，“医院治疗”和“日常行为限制”类别之间存在显著差异。在这两个得分中，与仅下背部或膝盖疼痛的受试者相比，下背部和膝盖都疼痛的受试者得分更高。在疼痛部位数量方面，“医院治疗”、“日常行为限制”和“自我治疗”类别之间存在显著差异；有两个或更多疼痛部位的受试者得分高于有一个疼痛部位的受试者。对于疼痛持续时间，“医院治疗”、“日常行为限制”和“自我治疗”类别之间存在显著差异；经历疼痛5年或更长时间的受试者得分高于经历疼痛少于6个月的受试者。
结论 我们发现社区居住的老年人使用五种疼痛应对方法（“医院治疗”、“日常积极应对”、“日常行为限制”、“自我治疗”和“休息”），并且“医院治疗”和“日常行为限制”是疼痛老年人中最常见的策略。
