Araştırma Makalesi
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More than just pain: Understanding pain in the geriatric population through social support and psychological factors

Yıl 2025, Cilt: 9 Sayı: 3, 439 - 447, 31.12.2025
https://doi.org/10.29058/mjwbs.1818478

Öz

Aim: Chronic pain is a common condition among the elderly, impairing physical function, cognitive ability, and psychological well-being. Psychological resilience and perceived social support may influence pain perception and treatment response, but limited research has addressed these factors in older adults.
To investigate the effects of psychological resilience and perceived social support on pain severity and psychological factors in elderly individuals with chronic pain.
Material and Methods: A total of 112 elderly participants were included. Pain severity was measured using the Visual Analog Scale (VAS). Psychological variables were assessed using the Geriatric Depression Scale (GDS), Geriatric Anxiety Scale (GAS), Psychological Resilience Scale for Adults (PRSA), and Multidimensional Scale of Perceived Social Support. Participants were classified as benefiting from treatment if they experienced ≥30% reduction in VAS scores. Statistical analyses included Chi-square test, Mann–Whitney U test, Spearman’s correlation, and binary logistic regression.
Results: Of the participants, 81 (72.3%) benefited from treatment. Those who benefited had significantly lower GDS and GAS scores and higher PRSA scores (p < 0.001). Post-treatment VAS scores positively correlated with depression and anxiety, and negatively with psychological resilience. In logistic regression analysis, higher depression (p = 0.018) and perceived social support (p = 0.006) were associated with lower odds of treatment response, whereas higher psychological resilience (p = 0.010) predicted greater likelihood of improvement.
Conclusion: Psychological resilience, depression, anxiety, and social support are significant factors in chronic pain management among the elderly. Integrating psychosocial approaches with conventional treatments may improve outcomes in this population.

Kaynakça

  • Mahishale V. Ageing world: Health care challenges. Journal of the Scientific Society. 2015;42(3):138-143. https://doi.org/10.4103/0974-5009.165540
  • Tarsuslu ST, Tutun Yumin E, Ozturk A, Sertel M, Yumin M. Relationship between pain, health status, mobility, and daily living activity levels in elderly individuals living at home. Turk J Phys Med Rehabil. 2011;57:216-220. (in Turkish). https://doi.org/10.4274/tftr.78557
  • Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976-1982. https://doi.org/10.1097/j.pain.0000000000001939
  • Elbi H. Psychiatric evaluation in chronic pain. TOTBİD Journal 2017;16:169-173. (in Turkish) https://doi.org/10.14292/totbid.dergisi.2017.25
  • Tanrıverdi G, Okanlı A, Çetin H, Ozyazicioglu N, Sezgin H, Kararman H, et al. Pain in the elderly population. Turk Geriatri Derg. 2009;12(4):190-197. [Article in Turkish]
  • Köksal T, Sarıkaya S. Kronik bel ağrılı hastalarda uyku kalitesi; Uykunun ağrı, fonksiyonel durum ve yaşam kalitesi ile ilişkisi. Batı Karadeniz Tıp Dergisi. 2021,5(3), 481-487. https://doi.org/10.29058/mjwbs.1034438
  • Dominick CH, Blyth FM, Nicholas MK. Unpacking the burden: understanding the relationships between chronic pain and comorbidity in the general population. Pain. 2012;153:293-304. https://doi.org/10.1016/j.pain.2011.09.018
  • Martinnen MK, Kautiainen H, Haanpaa M, Pohjankoski H, Vuorimaa H, Hintikka J, et al. Pain-related factors in older adults. Scand J Pain. 2019;19(4):797-803. https://doi.org/10.1515/sjpain-2019-0039
  • Luthar SS, Cicchetti D, Becker B. The construct of resilience: a critical evaluation and guidelines for future work. Child Dev. 2000;71:543–562. https://doi.org/10.1111/1467-8624.00164
  • Karoly P, Ruehlman LS. Psychological “resilience” and its correlates in chronic pain: findings from a national community sample. Pain. 2006;123(1-2):90-97. https://doi.org/10.1016/j.pain.2006.02.014
  • Bauer H, Emeny RT, Baumert J, Ladwig KH. Resilience moderates the association between chronic pain and depressive symptoms in the elderly. Eur J Pain. 2016;20:1253-1265. https://doi.org/10.1002/ejp.850
  • Master SL, Eisenberger NI, Taylor SE, Naliboff BD, Shirinyan D, Lieberman MD. A picture’s worth: Partner photographs reduce experimentally induced pain. Psychol Sci. 2009;20:1316-1318. https://doi.org/10.1111/j.1467-9280.2009.024
  • Eisenberger NI, Master SL, Inagaki TK, Taylor SE, Shirinyan D, Lieberman MD, et al. Attachment figures activate a safety signal-related neural region and reduce pain experience.Proc Natl Acad Sci. 2011;108:11721-11726. https://doi.org/10.1073/pnas.1108239108
  • Prowse M. Postoperative pain in older people: A review of the literature. J Clin Nurs. 2007;16:84-97. https://doi.org/10.1111/j.1365-2702.2005.01482.x
  • Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990;13(4):227-236. https://doi.org/10.1002/nur.4770130405
  • Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, et al. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine. 2008;33(1), 90-94. https://doi.org/10.1097/BRS.0b013e31815e3a10
  • Gur G, Turgut E, Dilek B, Baltaci G, Bek N, Yakut Y. Validity and reliability of visual analog scale foot and ankle: the Turkish version. The Journal of Foot and Ankle Surgery. 2017;56(6), 1213-1217. https://doi.org/10.1053/j.jfas.2017.06.001
  • Yaray O, Akesen B, Ocakoğlu G, Aydınlı U. Omurga kırıklı hastalarda görsel analog skala omurga skoru Türkçe versiyonunun geçerliliği. Acta Orthopaedica et Traumatologica Turcica. 2011;45(5):353-358.
  • Yesavage JA. Geriatric depression scale. Psychopharmacol Bull. 1988; 24: 709-711.
  • Ertan T, Eker E. Reliability, validity, and factor structure of the geriatric depression scale in Turkish elderly: are there different factor structures for different cultures?. International Psychogeriatrics. 2000;12(2), 163-172. https://doi.org/10.1017/S1041610200006293
  • Segal DL, Granier KL, Pifer MA, Stone LE. Geriatric Anxiety Scale. In: Gu D, Dupre ME, eds. Encyclopedia of Gerontology and Population Aging. Cham: Springer International Publishing. 2017:1–7. https://doi.org/10.1007/978-3-319-69892-2_1103-1.
  • Karahan FS, Hamarta E, Karahan AY. The Turkish adaptation and psychometric properties of the Geriatric Anxiety Scale. Mental Illness. 2018;10(1):1-5. https://doi.org/10.1108/mi.2018.7580
  • Zimet GD, Dahlem NW, Zimet SG, Farley GK.. The Multidimensional Scale of Perceived Social Support. J Pers Assess. 1988; 52: 30-41. https://doi.org/10.1207/s15327752jpa5201_2
  • Başol G. Validity and reliability of the multidimensional scale of perceived social support-revised, with a Turkish sample. Social Behavior and Personality: an international journal. 2008;36(10):1303-1313. https://doi.org/10.2224/SBP.2008.36.10.1303
  • Friborg O, Hjemdal O, Rosenvinge JH, Martinussen M. A New Rating Scale for Adult Resilience: What are the Central Protective Resources behind Healthy Adjustment? Int J Methods Psychiatr Res. 2003;12:65-76. https://doi.org/10.1002/mpr.143
  • Yavaş SP, Baysan C. Turkish validation of a resilience scale from older people’s perspectives: resilience scale for older adults. PeerJ, 2025;13:e18837. https://doi.org/10.7717/peerj.18837
  • McWilliams LA, Cox BJ, Enns MW. Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample. Pain. 2003;106:127–133. https://doi.org/10.1016/S0304-3959(03)00301-4
  • Zhao SS, Jones GT, Hughes DM, Moots RJ, Goodson NJ. Depression and anxiety symptoms at TNF inhibitor initiation are associated with impaired treatment response in axial spondyloarthritis. Rheumatology. 2021;60(12):5734-5742. https://doi.org/10.1093/rheumatology/keab242
  • Mossey JM, Gallagher RM. Evaluation of the effects of pain and depression on the physical functioning of continuing care retirement community residents: implications for the treatment of pain in older individuals. Pain Med. 2001;2(3):247-48. https://doi.org/10.1111/j.1526-4637.2001.pme01039-20.x
  • Castro M, Quarantini LC, Daltro C, Pires-Caldas M, Koenen KC, Oliveira IRD. Comorbid depression and anxiety symptoms in chronic pain patients and their impact on health-related quality of life. Arch Clin Psychiatry (São Paulo). 2011;38:126-29. https://doi.org/10.1590/S0101-60832011000400002
  • Zamanian H, Amini-Tehrani M, Jalali Z, Daryaafzoon M, Ala S, Tabrizian S, et al. Perceived social support, coping strategies, anxiety and depression among women with breast cancer: Evaluation of a mediation model. Eur J Oncol Nurs. 2021;50: 101892. https://doi.org/10.1016/j.ejon.2020.101892
  • Almeida B, Capela A, Pinto J, Santos V, Silva CG, Rosa MCN. Relação entre suporte social percebido e catastrofização em indivíduos com dor crônica do joelho. BrJP. 2019;2:55-60. https://doi.org/10.5935/2595-0118.20190011
  • Bernardes SF, Brandão T, de Matos MO, Ferreira-Valente A. Social support for functional dependence, activity patterns, and chronic pain outcomes: A cross-lagged mediation panel study. Health Psychology. 2024;43(7):488. https://doi.org/10.1037/hea0001370
  • Musich S, Wang SS, Schaeffer JA, Kraemer S, Wicker E, Yeh CS. The association of resilience, social connections, and internal locus of control with pain outcomes among older adults. Geriatr Nurs. 2022;48:43-50. https://doi.org/10.1016/j.gerinurse.2022.08.011

Ağrıdan daha fazlası: Sosyal destek ve psikolojik faktörler bağlamında geriatrik popülasyonda ağrının anlaşılması

Yıl 2025, Cilt: 9 Sayı: 3, 439 - 447, 31.12.2025
https://doi.org/10.29058/mjwbs.1818478

Öz

Amaç: Kronik ağrı yaşlılarda sık görülen bir durum olup fiziksel işlevi, bilişsel yetiyi ve psikolojik iyilik halini bozabilir. Psikolojik dayanıklılık ve algılanan sosyal destek, ağrı algısını ve tedavi yanıtını etkileyebilir; ancak bu faktörleri yaşlı yetişkinlerde ele alan araştırmalar sınırlıdır.
Kronik ağrısı olan yaşlı bireylerde psikolojik dayanıklılık ve algılanan sosyal desteğin ağrı şiddeti ve psikolojik faktörler üzerindeki etkilerini incelemek.
Gereç ve Yöntemler: Toplam 112 yaşlı katılımcı çalışmaya dâhil edildi. Ağrı şiddeti Görsel Analog Skala (VAS) ile ölçüldü. Psikolojik değişkenler Geriatrik Depresyon Ölçeği (GDÖ), Geriatrik Anksiyete Ölçeği (GAÖ), Yetişkinler için Psikolojik Dayanıklılık Ölçeği (Y-PDÖ) ve Çok Boyutlu Algılanan Sosyal Destek Ölçeği ile değerlendirildi. VAS skorlarında ≥%30 azalma yaşayan katılımcılar “tedaviden yararlandı” olarak sınıflandırıldı. İstatistiksel analizlerde Ki-kare testi, Mann–Whitney U testi, Spearman korelasyonu ve ikili lojistik regresyon kullanıldı.
Bulgular: Katılımcıların 81’i (%72,3) tedaviden yarar gördü. Yararlananlarda GDÖ ve GAÖ puanları anlamlı düzeyde daha düşük, Y-PDÖ puanları ise daha yüksekti (p < 0,001). Tedavi sonrası VAS skorları depresyon ve anksiyete ile pozitif, psikolojik dayanıklılık ile negatif yönde koreleydi. Lojistik regresyon analizinde daha yüksek depresyon (p = 0,018) ve algılanan sosyal destek (p = 0,006) daha düşük tedavi yanıtı olasılığı ile ilişkiliyken, daha yüksek psikolojik dayanıklılık (p = 0,010) iyileşme olasılığını artırdı.
Sonuç: Psikolojik dayanıklılık, depresyon, anksiyete ve sosyal destek, yaşlılarda kronik ağrı yönetiminde önemli faktörlerdir. Psikososyal yaklaşımların geleneksel tedavilerle entegrasyonu, bu popülasyonda sonuçları iyileştirebilir.

Kaynakça

  • Mahishale V. Ageing world: Health care challenges. Journal of the Scientific Society. 2015;42(3):138-143. https://doi.org/10.4103/0974-5009.165540
  • Tarsuslu ST, Tutun Yumin E, Ozturk A, Sertel M, Yumin M. Relationship between pain, health status, mobility, and daily living activity levels in elderly individuals living at home. Turk J Phys Med Rehabil. 2011;57:216-220. (in Turkish). https://doi.org/10.4274/tftr.78557
  • Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976-1982. https://doi.org/10.1097/j.pain.0000000000001939
  • Elbi H. Psychiatric evaluation in chronic pain. TOTBİD Journal 2017;16:169-173. (in Turkish) https://doi.org/10.14292/totbid.dergisi.2017.25
  • Tanrıverdi G, Okanlı A, Çetin H, Ozyazicioglu N, Sezgin H, Kararman H, et al. Pain in the elderly population. Turk Geriatri Derg. 2009;12(4):190-197. [Article in Turkish]
  • Köksal T, Sarıkaya S. Kronik bel ağrılı hastalarda uyku kalitesi; Uykunun ağrı, fonksiyonel durum ve yaşam kalitesi ile ilişkisi. Batı Karadeniz Tıp Dergisi. 2021,5(3), 481-487. https://doi.org/10.29058/mjwbs.1034438
  • Dominick CH, Blyth FM, Nicholas MK. Unpacking the burden: understanding the relationships between chronic pain and comorbidity in the general population. Pain. 2012;153:293-304. https://doi.org/10.1016/j.pain.2011.09.018
  • Martinnen MK, Kautiainen H, Haanpaa M, Pohjankoski H, Vuorimaa H, Hintikka J, et al. Pain-related factors in older adults. Scand J Pain. 2019;19(4):797-803. https://doi.org/10.1515/sjpain-2019-0039
  • Luthar SS, Cicchetti D, Becker B. The construct of resilience: a critical evaluation and guidelines for future work. Child Dev. 2000;71:543–562. https://doi.org/10.1111/1467-8624.00164
  • Karoly P, Ruehlman LS. Psychological “resilience” and its correlates in chronic pain: findings from a national community sample. Pain. 2006;123(1-2):90-97. https://doi.org/10.1016/j.pain.2006.02.014
  • Bauer H, Emeny RT, Baumert J, Ladwig KH. Resilience moderates the association between chronic pain and depressive symptoms in the elderly. Eur J Pain. 2016;20:1253-1265. https://doi.org/10.1002/ejp.850
  • Master SL, Eisenberger NI, Taylor SE, Naliboff BD, Shirinyan D, Lieberman MD. A picture’s worth: Partner photographs reduce experimentally induced pain. Psychol Sci. 2009;20:1316-1318. https://doi.org/10.1111/j.1467-9280.2009.024
  • Eisenberger NI, Master SL, Inagaki TK, Taylor SE, Shirinyan D, Lieberman MD, et al. Attachment figures activate a safety signal-related neural region and reduce pain experience.Proc Natl Acad Sci. 2011;108:11721-11726. https://doi.org/10.1073/pnas.1108239108
  • Prowse M. Postoperative pain in older people: A review of the literature. J Clin Nurs. 2007;16:84-97. https://doi.org/10.1111/j.1365-2702.2005.01482.x
  • Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990;13(4):227-236. https://doi.org/10.1002/nur.4770130405
  • Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, et al. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine. 2008;33(1), 90-94. https://doi.org/10.1097/BRS.0b013e31815e3a10
  • Gur G, Turgut E, Dilek B, Baltaci G, Bek N, Yakut Y. Validity and reliability of visual analog scale foot and ankle: the Turkish version. The Journal of Foot and Ankle Surgery. 2017;56(6), 1213-1217. https://doi.org/10.1053/j.jfas.2017.06.001
  • Yaray O, Akesen B, Ocakoğlu G, Aydınlı U. Omurga kırıklı hastalarda görsel analog skala omurga skoru Türkçe versiyonunun geçerliliği. Acta Orthopaedica et Traumatologica Turcica. 2011;45(5):353-358.
  • Yesavage JA. Geriatric depression scale. Psychopharmacol Bull. 1988; 24: 709-711.
  • Ertan T, Eker E. Reliability, validity, and factor structure of the geriatric depression scale in Turkish elderly: are there different factor structures for different cultures?. International Psychogeriatrics. 2000;12(2), 163-172. https://doi.org/10.1017/S1041610200006293
  • Segal DL, Granier KL, Pifer MA, Stone LE. Geriatric Anxiety Scale. In: Gu D, Dupre ME, eds. Encyclopedia of Gerontology and Population Aging. Cham: Springer International Publishing. 2017:1–7. https://doi.org/10.1007/978-3-319-69892-2_1103-1.
  • Karahan FS, Hamarta E, Karahan AY. The Turkish adaptation and psychometric properties of the Geriatric Anxiety Scale. Mental Illness. 2018;10(1):1-5. https://doi.org/10.1108/mi.2018.7580
  • Zimet GD, Dahlem NW, Zimet SG, Farley GK.. The Multidimensional Scale of Perceived Social Support. J Pers Assess. 1988; 52: 30-41. https://doi.org/10.1207/s15327752jpa5201_2
  • Başol G. Validity and reliability of the multidimensional scale of perceived social support-revised, with a Turkish sample. Social Behavior and Personality: an international journal. 2008;36(10):1303-1313. https://doi.org/10.2224/SBP.2008.36.10.1303
  • Friborg O, Hjemdal O, Rosenvinge JH, Martinussen M. A New Rating Scale for Adult Resilience: What are the Central Protective Resources behind Healthy Adjustment? Int J Methods Psychiatr Res. 2003;12:65-76. https://doi.org/10.1002/mpr.143
  • Yavaş SP, Baysan C. Turkish validation of a resilience scale from older people’s perspectives: resilience scale for older adults. PeerJ, 2025;13:e18837. https://doi.org/10.7717/peerj.18837
  • McWilliams LA, Cox BJ, Enns MW. Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample. Pain. 2003;106:127–133. https://doi.org/10.1016/S0304-3959(03)00301-4
  • Zhao SS, Jones GT, Hughes DM, Moots RJ, Goodson NJ. Depression and anxiety symptoms at TNF inhibitor initiation are associated with impaired treatment response in axial spondyloarthritis. Rheumatology. 2021;60(12):5734-5742. https://doi.org/10.1093/rheumatology/keab242
  • Mossey JM, Gallagher RM. Evaluation of the effects of pain and depression on the physical functioning of continuing care retirement community residents: implications for the treatment of pain in older individuals. Pain Med. 2001;2(3):247-48. https://doi.org/10.1111/j.1526-4637.2001.pme01039-20.x
  • Castro M, Quarantini LC, Daltro C, Pires-Caldas M, Koenen KC, Oliveira IRD. Comorbid depression and anxiety symptoms in chronic pain patients and their impact on health-related quality of life. Arch Clin Psychiatry (São Paulo). 2011;38:126-29. https://doi.org/10.1590/S0101-60832011000400002
  • Zamanian H, Amini-Tehrani M, Jalali Z, Daryaafzoon M, Ala S, Tabrizian S, et al. Perceived social support, coping strategies, anxiety and depression among women with breast cancer: Evaluation of a mediation model. Eur J Oncol Nurs. 2021;50: 101892. https://doi.org/10.1016/j.ejon.2020.101892
  • Almeida B, Capela A, Pinto J, Santos V, Silva CG, Rosa MCN. Relação entre suporte social percebido e catastrofização em indivíduos com dor crônica do joelho. BrJP. 2019;2:55-60. https://doi.org/10.5935/2595-0118.20190011
  • Bernardes SF, Brandão T, de Matos MO, Ferreira-Valente A. Social support for functional dependence, activity patterns, and chronic pain outcomes: A cross-lagged mediation panel study. Health Psychology. 2024;43(7):488. https://doi.org/10.1037/hea0001370
  • Musich S, Wang SS, Schaeffer JA, Kraemer S, Wicker E, Yeh CS. The association of resilience, social connections, and internal locus of control with pain outcomes among older adults. Geriatr Nurs. 2022;48:43-50. https://doi.org/10.1016/j.gerinurse.2022.08.011
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Geriatri ve Gerontoloji, Psikiyatri
Bölüm Araştırma Makalesi
Yazarlar

Zuhal Koç Apaydın 0000-0003-3893-5314

Nefise Demir 0000-0001-6683-9085

Hatice Gülşah Karataş 0000-0003-2812-485X

Gönderilme Tarihi 5 Kasım 2025
Kabul Tarihi 12 Aralık 2025
Yayımlanma Tarihi 31 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 9 Sayı: 3

Kaynak Göster

Vancouver 1.Koç Apaydın Z, Demir N, Gülşah Karataş H. More than just pain: Understanding pain in the geriatric population through social support and psychological factors. Med J West Black Sea [Internet]. 01 Aralık 2025;9(3):439-47. Erişim adresi: https://izlik.org/JA62GA69SX

Batı Karadeniz Tıp Dergisi, Zonguldak Bülent Ecevit Üniversitesi tarafından yayımlanan, uluslararası, hakemli ve açık erişimli bir dergidir. İlk sayısı 2017 yılında yayımlanan dergi, yılda üç kez (Nisan, Ağustos ve Aralık aylarında) yayımlanmakta olup Türkçe ve İngilizce makalelere yer verir.