title: Moderating effect of communication difficulty on the relationship between depression and pain: a study on community-dwelling older adults in Hong Kong.
abstract: OBJECTIVE
  This study examined the relationship between depression and pain, and the moderating effect of communication difficulty on this relationship, among community-dwelling older adults in Hong Kong.
  
  
  METHODS
  We used logistic regression to analyze secondary data regarding 12,402 Chinese older adults applying for long-term care service in Hong Kong in 2012.
  
  
  RESULTS
  Approximately 30% of participants were depressed and 37% experienced communication difficulty. Depression was associated with increased pain. Communication difficulty was found to moderate the relationship between depression and pain. Pain scores increased more when individuals who experienced communication difficulty reported being depressed, compared to those who did not experience communication difficulty.
  
  
  CONCLUSIONS
  The moderating effect of communication difficulty may be explained by the interaction between depression and communication difficulty. Participants who were depressed and concurrently experienced communication difficulty may be more likely to catastrophize their pain and may tend to report or experience more pain. Health care professionals need to be aware of the different effects of communication difficulty on the pain experiences of older adults. Psychosocial intervention may be provided to minimize older adults' communication barriers to pain management.
authors.affiliation: a Department of Social Work , Chinese University of Hong Kong , Shatin , Hong Kong.
authors.forename: Wallace Chi Ho
authors.initials: WC
authors.lastname: Chan
authors.forename: Chi Wai
authors.initials: CW
authors.lastname: Kwan
authors.forename: Iris
authors.initials: I
authors.lastname: Chi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003147:Communication Disorders / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D010146:Pain / Q000453:epidemiology*
keywords: Chinese; communication; depression; moderating effect; pain