title: What do we mean by "older adults' persistent pain self-management"? A concept analysis.
abstract: BACKGROUND
  No standard definition exists for the concept "persistent pain self-management" or how it should be defined in relation to older adults. Poorly defined concepts can result in misunderstandings in the clinical setting and can hinder research through difficulties identifying or measuring the concept.
  
  
  OBJECTIVE
  To ascertain attributes, referents, antecedents, and consequences of the concept older adults' persistent pain self-management and develop a theoretical definition.
  
  
  METHODS
  Rodgers evolutionary model of concept analysis was used to systematically analyze articles from the academic and grey literature (N = 45). Data were extracted using standardized extraction forms and analyzed using thematic analysis.
  
  
  RESULTS
  This concept was discussed in three ways: as an intervention, in reference to everyday behaviors, and as an outcome. Five defining attributes were identified: multidimensional process, personal development, active individuals, symptom response, and symptom control. Patients' perceived need and ability to manage pain with support from others is necessary for pain self-management to occur. Numerous physical, psychological, and social health consequences were identified. A theoretical definition is discussed.
  
  
  CONCLUSIONS
  Our findings have clarified existing use and understanding regarding the concept of older adults' persistent pain self-management. We have identified three areas for future development: refinement of the attributes of this concept within the context of older adults, an exploration of how providers can overcome difficulties supporting older adults' persistent pain self-management, and a clarification of the overall theoretical framework of older adults' persistent pain self-management.
authors.affiliation: Academic Primary Care, University of Aberdeen, Aberdeen, UK.
authors.forename: Carrie
authors.initials: C
authors.lastname: Stewart
authors.forename: Pat
authors.initials: P
authors.lastname: Schofield
authors.forename: Alison M
authors.initials: AM
authors.lastname: Elliott
authors.forename: Nicola
authors.initials: N
authors.lastname: Torrance
authors.forename: Suzanne
authors.initials: S
authors.lastname: Leveille
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D059350:Chronic Pain / Q000523:psychology; D006801:Humans; D059408:Pain Management; D012107:Research Design; D012648:Self Care
keywords: Aged; Chronic Pain; Concept Development; Concepts; Pain; Pain Management; Self-Management