Alicja Marzec

The determinants of coping with pain in chronically ill geriatric patients – the role of a sense of coherence

Background Given the rising population of the elderly in modern societies, the concern for their good functioning poses a challenge for the 21st century medicine and social services. Senior citizens are at an increased risk of developing chronic conditions, which in turn increase discomfort associated with physiological processes of aging. Sensations of pain have a particular influence on the mentioned discomfort, and pain is prevalent among older people. Therefore, from the perspective of an elderly person and senior care, it is crucial to identify determinants of effective coping with chronic pain. Objectives The aim of the research was to assess the relationship between a sense of coherence (SOC) and pain-coping strategies in chronically ill seniors. A total number of 188 individuals were included in the study, of whom 117 were female subjects and 71 were male subjects, with a mean age of 68.38 (standard deviation [SD] =6.35) years in the studied group. Subjects were sampled based on a diagnosis of a chronic medical illness with chronic pain as one of the major symptoms. Methods The Polish adaptation of the Orientation to Life Questionnaire (SOC-29) to assess an SOC, the Coping Strategies Questionnaire (CSQ) to assess pain-coping strategies, and the visual analog scale (VAS) to assess pain intensity were used in the study. Results and conclusion The mean score of respondents’ SOC was 133.44 (SD =24.35). Among most common pain-coping strategies used by the respondents were prayer and hope, and the declaration of coping with pain while redefining pain was the least often used coping strategy in the studied group. Individuals with stronger SOC were less prone to catastrophizing and more often declared that they were coping with and could control and reduce pain.

ANALYSIS OF PROBLEMS AND THEIR DETERMINANTS AMONG FAMILY CAREGIVERS TAKING CARE OF CHRONICALLY ILL PEOPLE

Introduction. All over the world, family caregivers constitute the main pillar of the state care system. Nevertheless, they usually do not receive the sufficient institutional support. Therefore, an attempt has been made in order to identify the most frequently appearing problems among the caregivers and to define factors which influence their behaviour. Materials and methods. The research was conducted among 300 caregivers who take care of the chronically ill family members in domestic conditions. The research was conducted with the use of the diagnostic poll. In order to collect data, four following diagnostic tools were used: the modified Bartels Scale, the Caregivers Strain Index, Becks Depression Scale and the authors questionnaire. Results. Despite of the high self-evaluation in preparation of the caregivers, most of them pointed out numerous problems concerning the daily care of the chronically ill people. The respondents most frequently pointed out the following: the difficulties with moving the ill person (55.7%), lack of time (50.0%), difficulties with hygienic activities (49.3%) and difficulties with obtaining financial support (38.7%). Majority of the caregivers (69.3%) suffered from a great level of strain, while 43.7% diagnosed themselves with a gentle stage of depression. Occurrence of strain and depression and their intensity was strictly connected with the deficit level of wards self-service, intensity of care and the level of caregivers preparation. Functioning of the institutions responsible for supporting the chronically ill people and their families was assessed negatively by most of the caregivers (76%). Conclusions. Family caregivers of the chronically ill people pointed out a number of problems connected with daily care. They have also revealed a significant level of strain. The difficult situation of caregivers is affected by numerous factors, one of which is lack of the interdisciplinary support in fulfilling the caring function. For this reason, there is an urgent necessity of change in the current state care system, which would enable effective care-taking in domestic conditions.