Promoting functional autonomy versus dependence in older adults with chronic pain: social support buffering effect

Abstract

Background: When chronic pain (CP) disrupts older adults’ life, social support (SS) may be key in promoting functional ability and healthy ageing. Research on pain-related SS has mostly investigated its direct effects on pain-related outcomes, also showing that it has different implications, depending on whether it promotes functional autonomy or dependence. Nevertheless, research lacks in addressing the buffering effect of pain-related SS for functional autonomy/dependence. Therefore, this study aimed at investigating the buffering effect of formal SS (e.g., day-care centers) for functional autonomy/dependence on the relationship between pain intensity and pain-related disability, among older adults with CP, and examining the mechanisms that may account for such effect, namely, the role of pain-related self-efficacy and pain-related fear. Methods: 170 older adults (Mage=78) with musculoskeletal CP, attending day-care centers, participated in a 3-month prospective study (3 measurements). Participants completed the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Brief Pain Inventory, the Pain Self-Efficacy Questionnaire and the Tampa Scale of Kinesiophobia. Findings: Structural Equation Modeling confirmed that perceived promotion of autonomy(T1) moderated the relationship between pain intensity(T1) and pain-related disability(T2); this moderation was fully mediated by pain-related self-efficacy. Discussion: SS for functional autonomy suppressed the impact of pain intensity on pain-related disability. These findings highlight the importance of providing SS for functional autonomy, which should translate into formal caregivers’ practices and awareness regarding older adults suffering from CP. Pain-related SS for functional autonomy might be a way to reduce the impact of CP on older adults’ healthy ageing.