title: Fluctuation between Powerlessness and Sense of Meaning--A Qualitative Study of Health Care Professionals' Experiences of Providing Health Care to Older Adults with Long-Term Musculoskeletal Pain.
abstract: BACKGROUND
  There is an increasing number of older adults living with long-term musculoskeletal pain and related disabilities. These problems are frequently unrecognized, underreported, and inadequately treated. Since many older adults desire to remain at home for as long as possible, it is important that individualized and holistically tailored care is provided in these settings. However, there is a complexity in providing care in this context. The aim of this study was to describe health care professionals' experiences of providing health care to older adults living with long-term musculoskeletal pain at home.
  
  
  METHODS
  The phenomenon, "To provide health care to older adults living with long-term musculoskeletal pain at home", was studied using reflective lifeworld research (RLR) which is based on phenomenological epistemology. Ten health care providers (nurse, physiotherapists, and occupational therapists) were interviewed and data was analysed.
  
  
  RESULTS
  The health care professional's emotions fluctuated between powerlessness and meaningfulness. Needs, opportunities, understanding and respect had to be balanced in the striving to do good in the provision of health care in differing situations. Caring for older adults with long-term pain required courage to remain in the encounter despite feelings of insecurity and uncertainty about the direction of the dialogue. The essence of caring for older adults with long-term pain consisted of the following constituents: Sense of powerlessness; striving to provide good health care; and understanding and respect.
  
  
  CONCLUSIONS
  The findings indicated that the health care professionals strived to do good and to provide health care that was holistic and sensitive to the older adults' needs. A significant sense of powerlessness in the situation was experienced by the health care professionals. These findings address and support the need to develop methods that can be used to guide health care providers who support older adults in the context of their homes.
authors.affiliation: School of Health and Education, Health and Learning Research Centre: Aging and Long-Term Health Problems, University of Skövde, Skövde, Sweden. mia.berglund@his.se.
authors.forename: Mia
authors.initials: M
authors.lastname: Berglund
authors.affiliation: Academy of Care, Working Life and Social Welfare, University of Borås, Borås, Sweden. kristina.nassen@hb.se.
authors.forename: Kristina
authors.initials: K
authors.lastname: Nässén
authors.affiliation: School of Health and Education, Health and Learning Research Centre: Aging and Long-Term Health Problems, University of Skövde, Skövde, Sweden. catharina.gillsjo@his.se.|College of Nursing, University of Rhode Island, Kingston, USA. catharina.gillsjo@his.se.
authors.forename: Catharina
authors.initials: C
authors.lastname: Gillsjö
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D059350:Chronic Pain / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation; D056348:Emotional Intelligence; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006699:Home Care Services; D006801:Humans; D008297:Male; D059352:Musculoskeletal Pain / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D020380:Needs Assessment; D011361:Professional Competence; D036301:Qualitative Research; D013548:Sweden