An Analysis of Factors Associated with Chronic Musculoskeletal Pain, Pain Management Preferences, Coping Strategies, and Health-Related Quality of Life Among Older People: A Cross-Cultural Study.

Introduction: Chronic musculoskeletal pain is common among older adults (OAs). This study aimed to identify and describe the characteristics of chronic musculoskeletal pain, pain management, and coping strategies among OAs from Turkey, Croatia, and Romania. The study also aimed to explore cultural differences in pain experience and management.

Methods: A total of 337 OAs with chronic pain participated: 100 from Turkey, 131 from Croatia and 106 from Romania. The mean age was 76.3 years in Croatia, 73.1 years in Romania, and 74.0 years in Turkey. The majority of participants in Croatia and Romania were female, while the majority of participants in Turkey were male. A structured questionnaire was used to explore four main topics, including factors influencing pain, coping strategies, management strategies, and health-related quality of life.

Results: Significant differences in pain-related factors, pain management, and coping strategies were found between the three countries (p≤0.05). Physical activity, relaxation exercises, and warm showers/hot packs were associated with pain reduction. Climbing stairs was a significant pain increasing factor in both Romania and Turkey, with participants in these countries more than 2.5 times more likely to report it as a pain increasing factor compared to Croatia. Sitting had the opposite effect in Romania and Turkey. Significant predictors included higher visual analog scale-VAS scores, which were associated with worse self-rated health. Country of origin also influenced health perceptions, with Romanians less likely to report better health than Croatians.

Discussion: The findings highlight the cultural implications of pain perception and management. They reveal that older adults' coping strategies and health-related quality of life are shaped not only by physical factors but also by beliefs and health perceptions unique to each country and influenced by culture. Education, including physical activity, medication use, and non-pharmacological methods like physiotherapy and interventions that consider cultural context can enhance pain control and health among older adults.