Illness representations of restricting back pain: The older person's perspective

Objective: Back pain is the most common type of pain reported by older adults, leading to considerable morbidity and cost. Yet little is known about the segment of the population ≥80 years old that can be used to guide care in this age group. Illness representations provide a useful framework to understand older adults' beliefs and perceptions of their back pain. The objective of this study was to understand illness representations of back pain, severe enough to restrict activity (restricting back pain). Design: Qualitative research using semi-structured interviews. Subjects: Twenty-three community-living older adults ≥80 years old with restricting back pain. Methods: We used an interview guide to stimulate discussion about how older adults understand and perceive living with restricting back pain. Thematic codes were created to categorize the nuances of participants' restricting back pain experiences. Results: Participants reported five important components of illness representation: 1) identity, the label and symptoms individuals assign to the illness; 2) timeline, the individual's perceived clinical course of the illness; 3) cause, the individual's perceived etiology of the illness; 4) consequences, the perceived impact of the illness; and 5) cure-control, the perceived degree to which cure or management is possible/likely. Conclusions: Thematic analysis revealed that restricting back pain in older adults has variable and noteworthy physical, psychological and social consequences. There are several components of the illness representation of restricting back pain, specifically, the perceptions of consequences and control that may offer potential targets for clinical intervention.