Comparisions of Life Story Interviews between Young and Older Patients with Chronic Pain
Location
DeSantis Room 1049
Format Type
Plenary
Format Type
Paper
Start Date
17-1-2020 9:15 AM
End Date
17-1-2020 9:35 AM
Abstract
We wondered what’s different for older versus younger people with chronic pain. We interviewed 19 adults, ages 65 to 85, and 19 adults less than 35 years old with chronic pain, first by an older physician, and then, 2-4 weeks later, by a younger medical student, both using the semi-structured Northwestern University Life Story Interview. Data was analyzed in an iterative, comparative process using a constructivist, grounded theory approach as inspired by Charmaz. Common themes for all patients consisted of frustration with the medical system and their physicians for not helping them. Also shared was a belief that pain had mechanical causes and could be cured through mechanical means (especially surgery). Some unique categories emerged for the older patients, including surprise at their other medical co-morbidities, remorse and regret for things not done, surprise at being “old” when they didn’t feel “old,” anger at stigmatization for being old, and more self-evaluation and self-reflection. Comparing life stories by interviewer, we found that older patients consistently presented themselves more negatively and more dysfunctional to the older physician than to the younger medical student. They presented themselves as having more pride in their accomplishments and lives, having a sense they could transcend their suffering, and having found meaning and purpose in their suffering. In short, they were more heroic to the younger medical student and more angry, bitter, and dysfunctional to the older family physician. We confirm Bamburg’s observations that stories are always told for an audience and for a purpose.
Keywords
chronic pain, aging, life story, life story interview, meaning and purpose, self-reflection, interviewer influences
Comparisions of Life Story Interviews between Young and Older Patients with Chronic Pain
DeSantis Room 1049
We wondered what’s different for older versus younger people with chronic pain. We interviewed 19 adults, ages 65 to 85, and 19 adults less than 35 years old with chronic pain, first by an older physician, and then, 2-4 weeks later, by a younger medical student, both using the semi-structured Northwestern University Life Story Interview. Data was analyzed in an iterative, comparative process using a constructivist, grounded theory approach as inspired by Charmaz. Common themes for all patients consisted of frustration with the medical system and their physicians for not helping them. Also shared was a belief that pain had mechanical causes and could be cured through mechanical means (especially surgery). Some unique categories emerged for the older patients, including surprise at their other medical co-morbidities, remorse and regret for things not done, surprise at being “old” when they didn’t feel “old,” anger at stigmatization for being old, and more self-evaluation and self-reflection. Comparing life stories by interviewer, we found that older patients consistently presented themselves more negatively and more dysfunctional to the older physician than to the younger medical student. They presented themselves as having more pride in their accomplishments and lives, having a sense they could transcend their suffering, and having found meaning and purpose in their suffering. In short, they were more heroic to the younger medical student and more angry, bitter, and dysfunctional to the older family physician. We confirm Bamburg’s observations that stories are always told for an audience and for a purpose.