Rehabilitation strategies for older patients with pain syndromes based on their perceptions of their conditions
Elderly patients more often than other age groups have pain in combination with anxiety and depressive disorders. Objective: to define the frequency of pain and its combination with anxiety and depression in older patients treated in multidepartment hospital for optimization of rehabilitation strategies and individual approach to therapy based on the patient's perception of their illness. Materials and methods: we included 60 hospitalized patients older than 60 years and 119 patients as a control group (ages 18 to 60 years). A comprehensive pain assessment estimated by the questionnaire, anxiety and/or depressive disorders were studied using Hospital Anxiety and Depression Scale (HADS), Beck Scale of Depression and test of Spilberger- Khanin. Results: 80% of older patients experienced pain at the moment of the study; 53.33% of patients showed highly elevated reactive anxiety, 76.67% of cases had high scores of personal anxiety. Depression according to HADS was detected in 58.33%, according to Beck Depression Scale - in 90% of older patients. Anxiety symptoms were revealed in 76,67% of older patients. Patients who suffered from pain every day, in 91,67% cases had anxiety symptoms, most of them showed high scores of reactive and personal anxiety (63,8% and 88,89% accordingly). Most of the patients (69,94%), who experienced pain every day during last three months, had severe and moderate symptoms of depression according to Beck scale. Conclusion : Elderly patients have higher levels of anxiety, can be more sensitive to the disease and prone to disasterization their condition. Assessment of psychological status should be considered in pain management of older patients. We recommend to assess anxiety-and-depressive disorders for every old patient with chronic pain and use her/his personal results in individual rehabilitation strategy.