relationship between specific assessments of spiritual behavior, health self-assessment, to

reports of pain report and the use of analgesic medications among a group of older adults

recovering from hip replacements surgery.

 Background and Significance

Chronic Pain in the Older Adult

 Pain is defined as a noxious physical and emotional experience. Although similar

for all age groups, elderly adults appear to have a higher incidence of chronic pain. The

only measure of the presence and intensity of pain is the report of the person

experiencing the pain (Ferrell, 2000). Nociceptor pain, including chronic pain, begins

with the activation of special receptors and afferent fibers by peripheral stimuli usually

associated with processes involving tissue damage and inflammation (Ekblom & Rydh-

Rinder, 1998). Such pain may include musculoskeletal pain, ischemic pain, visceral pain,

and myofascial pain. There is little empirical evidence that biological or physiological

measurements correlates to the degree of pain expressed by the elderly individual

(Gagliese & Melzack, 1997). In other words, to a large extent the 'experience' of pain is

subjective.

 Among the elderly, research indicates that more than 90% of the elderly experience

pain in the musculoskeletal system (Anderson, Ejlertsson, Lenden & Rosenberg, 1993).

Chronic arthritic joint pain begins in the upper extremities such as shoulders and then

progresses to the lower extremity as an individual ages (Anderson, et al. 1993; Mobily ,

et al. 1994). This site of the pain can greatly affect severity of chronic pain as well as the

degree of functional impairment.