Barriers to chronic pain management in community-dwelling low-income older adults: Home-visiting nurses’ perspectives

2016 
Summary This study identified barriers to effective chronic pain management for low-income community-dwelling older adults from home-visiting nurses' perspectives. Four focus group discussions investigated 23 nurses (five to six participants in each focus group) at local home-visiting nursing care centres in Suwon, Korea for data collection. Data were analyzed with inductive thematic analysis. Patient-related, nurse-related, and organizational barriers were identified. Patient-related barriers included limited understanding, lack of success in achieving compliance, continued use of traditional medicines, and financial hardship. Nurse-related barriers were limitations of managing chronic pain, inadequate knowledge and experience, lack of confidence, and uniform interventions. Organizational barriers included inadequate staffing and time constraints, few national support policies, unclear guidance, and limited access to available resources. The nurses' experiences in caring for older adults with chronic pain provided insights into how nurses perceived barriers to adequate pain management in community-based settings; this may be different from acute care settings. This understanding precedes development of innovative practice strategies for chronic pain management in primary healthcare services.
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