Exploring Everyday Functioning In Older Adults With Chronic Pain: New Insights With New Technology

1. Exploring Everyday Functioning In Older Adults With Chronic Pain: New Insights With New Technology Gemma Wilson¹, Derek Jones², Patricia Schofield³ & Denis Martin¹ ¹Teesside University, ²Glasgow Caledonian University, ³University of Greenwich BACKGROUND RESEARCH • The Sensecam will act as a visual diary and will be used each day to gather an overview of each individual’s environment and their social interactions. • Diary • Throughout the measurement period participants will also be asked to complete daily diaries in order to include any additional thoughts or feelings about their pain and/or their day-to-day activities. • The diary will enable researchers to gain subjective and personal information which may not be captured by the technology. • The diary will take the form of the Day Reconstruction Method (DRM, Kahneman, Krueger, Schkade, Schwarz & Stone, 2004). This method instructs individuals to reconstruct a sequence of events from the previous day and respond to questions and descriptive scales regarding these activities. • Semi-structured Interview • The data from the LifeShirt, the Sensecam and the diary will form the basis of an in-depth semi-structured interview which will be conducted after the measurement period has ended. The participant will be questioned about their day-to-day functioning including why their functioning was as it was, and whether it has changed since the development of chronic pain. • PART B: • In the second part of the study the acceptance, usability and experiences of the technology will be measured. • Questionnaires will be used to gather initial data (the Flow State questionnaire, Jackson & Marsh, 1996 and the Technology Acceptance Questionnaire, Venkatesh, Morris, Davis & Davis, 2003). • Semi-structured interviews will be conducted after the completion of the questionnaires to gather further information about the given answers. • More than half of older adults report persistent pain in the U.K. (Royal College of Physicians, British Geriatrics Society and British Pain Society, 2007). • Physical, psychological and social functioning are often reduced in chronic pain sufferers leading to consequences such as lowered fitness levels (Smeets, Wittink, Hidding, & Knottnerus, 2006) and depression (Arnow et al., 2006). • Furthermore, research has found that pain-related life interferences increase with age (Thomas, Peat, Harris, Wilkie, & Croft, 2004). • Research in this area often use self-report measures (e.g. Huijnen, Verbunt, Roelofs, Goossens & Peters, 2009) or ambulatory measures (e.g. de Bruin, Hartmann, Uebelhart, Murer & Zijkstra, 2008) to measure functioning, however, these tools have failed to gather sufficient information about an individual’s day-to-day functioning. AIMS • There are two main aims of the study: • To explore the day-to-day functioning of older adults suffering from chronic pain. • 2. To explore the usability, acceptance and experience of the technology used to measure levels of functioning. Fig. 1: The LifeShirt PROPOSED METHOD • There will be 2 parts to the study running in parallel and the same participants will be used in both parts. • Twenty participants will be recruited, all participants will be over 65 years old, retired, and living in the community, and will have experienced chronic pain for 3 or more months in 2 or more joints. Individuals with cognitive deficits, active cancer pain, and those awaiting surgery or who have undergone recent surgery will not be included. • PART A: • This will be a mixed methods study which will aim to explore the day-to-day experiences of older adults suffering from chronic pain. Participants will be measured over 7 days. • Quantitative research will be gathered using the LifeShirt (Vivo metrics Inc.) and the Sensecam (ViconRevue, Vicon Motion Systems Ltd.), or a similar technology. This quantitative data will be used to compliment qualitative data which will be collected using a diary and a semi-structured interview. • All of these measures will be analysed together to gain as much insight into the individual’s day-to-day functioning as possible. • LifeShirt • This is a non-invasive technology which includes an accelerometer, and the ability to gather physiological information, including, electrocardiograph (ECG) and blood pressure. See figure 1. • This technology will be used to monitor the body positions and movement of the individuals, as well as the physiological reactions to their pain and functioning. • Sensecam • This is a camera which the individual wears around their neck for the period which they want to record. Once turned on the camera automatically takes pictures using a fish-eye lens, from the viewpoint of the wearer. See figure 2. PROPOSED ANALYSIS • The results will help to gain an understanding of: • the everyday functioning of older adults suffering from chronic pain • the effectiveness of the tools in measuring everyday function • the participants’ acceptance, usability and experiences of using the measurement tools Fig 2: The Sensecam ACKNOWLEDGEMENTS This study will form a PhD funded by the Lifelong Health and Wellbeing Programme REFERENCES Arnow, B.A., et al. (2006). Comorbid depression, chronic pain, and disability in primary care. Psychosomatic Medicine, 68, 262-268. de Bruin, E.D., Hartmann, A., Uebelhart, D., Murer, K., & Zijkstra, W. (2008). Wearable systems for monitoring mobility-related activities in older people: a systematic review. Clinical rehabilitation, 22, 878-895. Huijnen, I.P.J., Verbunt, J.A., Roelofs, J., Goossens, M., & Peters, M. (2009). The disabling role of fluctuations in physical activity in patients with chronic low back pain. European Journal of Pain, 13, 1076-1079. Jackson, S.A. & Marsh, H.W. (1996). Development and Validation of a scale to measure optimal experience: The Flow State Scale. Journal of Sport and Exercise Psychology, 18, 17-35. Kahneman, D., Krueger, A.B., Schkade, D.A., Schwarz, N., & Stone, A.A. (2004). A survey method for characterizing daily life experience: The Day Reconstruction Method. Science, 306, 1776-1780. Royal College of Physicians, British Geriatrics Society and British Pain Society (2007). The assessment of pain in older people: nationalguidelines. Concise guidance to good practice series, No 8.London: Royal college of Physicians. Smeets, R.J.E.M., Wittink, H., Hidding, A., & Knottnerus, J.A. (2006). Do patients with chronic low back pain have a lower level of aerobic fitness than healthy controls? Are pain, disability, fear of injury, working status, or level of leisure time activity associated with the difference in aerobic fitness level? Spine, 31, 1, 90-97. Thomas, E., Peat, G., Harris, L. Wilkie, R., & Croft, P.R. (2004). The prevalence of pain and pain interference in a general population of older adults: cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP). Pain, 110, 361-368. Venkatesh, V., Morris, M.G., Davis, G.B., & Davis, F.D. (2003). User acceptance of information technology: Toward a unified view. MIS Quarterly, 27, 3, 425-478. Contact Information Gemma Wilson H8086576@Tees.ac.uk