A qualitative study of older adults seeking appropriate treatment to self-manage their chronic pain in rural North-East Thailand

BACKGROUND Many older adults suffer from chronic pain which decreases their functional capacity and reduces quality of life. Health behaviours and self-care during chronic illness and chronic pain can exert an important influence on health outcomes. The aims of this study were to (a) understand how older adult Thai individuals seek appropriate treatment to self-manage their chronic pain, and (b) to identify factors that contribute to effective pain self-management. METHODS Qualitative interviews were conducted with 32 older adults living in villages in north-east Thailand. Observations were also conducted with consenting individuals. Most interviews were audio-recorded and transcripts were coded and analysed using a grounded theory approach. RESULTS Six contextual determinants affected the way participants choose to self-manage their chronic pain, including: priority accorded to pain management; information and resource seeking skills; critical appraisal skills; access to pain-related information; access to treatment; and satisfaction and preferences for practitioners. Participants used several strategies to inform and develop their self-management plans: accessing and responding to information, sourcing resources, trial and error, evaluating treatment and evaluating practitioners. CONCLUSIONS Attempts to increase accessibility, affordability and acceptability of pain treatment can promote pain self-management in older Thais. These findings have important implications for health professionals and government organisations seeking to enhance the self-management of pain and quality of life in this population.