Original article
Survey of Pain Among Veterans in Western New York

https://doi.org/10.1016/j.pmn.2005.12.001Get rights and content

Abstract

Recent emphasis on pain and its impact on the health and well-being of individuals evoked the interest of health care providers about services needed for effective and efficient pain management. This study was undertaken to examine the feasibility of using a mailed survey to determine the prevalence, nature, and extent of pain being experienced by Western New York Veterans. The specific aims were to (1) determine the feasibility of using a mailed survey to obtain information about pain in a population of Veterans; (2) estimate the extent of pain in the sample; and (3) describe the nature and impact of the pain experienced by the respondents.

 A comprehensive survey was prepared by modifying preexisting, widely used pain-assessment tools to describe a Veteran group’s pain experience. It was mailed to a randomly selected sample of 150 Veterans registered at a primary care clinic at the Western New York Veterans Administration Health System. A 76% response rate (n = 114) was obtained.

 Respondents declared a wide variety of health problems, and 71% reported having pain. The average number of body parts affected was 4.4 of a possible 11. The average intensity of pain was moderate; 35% reported constant pain, and 85% reported the pain to be occurring for years. Seventy-nine respondents described their pain to be interfering with their life and well-being. Medication was the primary treatment approach and was reported as ineffective by 48%. Veterans’ satisfaction with specific aspects of pain treatment was mixed.

Section snippets

Statement of the problem

Before extensive planning and implementation of costly services for pain treatment were undertaken by the Veterans Administration Western New York Healthcare System (VA WNY HS), a more specific description of the extent and kind(s) of pain that groups of Veterans were experiencing was needed so that services could be planned responsively. Some questions that arose were as follows: What percentage of a given group of Veterans served by the medical center was experiencing pain? Was the pain

Background

The International Association for the Study of Pain (1994) defined pain as the unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage. It reduces quality of life and impairs functional status (Serlin, 1995). Pain crosses all ages, socioeconomic strata, and diagnostic categories; it is a concern in all health care settings. It is not a single dimension phenomenon. Pain can be a direct symptom of acute sources, such as a

Research questions

Five specific research questions were explored in this study to examine Veterans’ pain:

  • What percentage of Veterans in WNY are experiencing pain?

  • What are the characteristics of their pain?

  • How does pain impact on Veterans’ quality of life?

  • What kinds of treatment did WNY Veterans seek/receive for pain?

  • How do Veterans perceive the effectiveness of pain treatment they received?

Procedure

A written survey questionnaire was prepared to comprehensively assess the scope and nature of pain being experienced by Veterans in WNY, along with the kinds and satisfaction with pain treatment received by the target group. After institutional review board approval was obtained, a random sample was selected and survey questionnaires were mailed using the Dillman’s Total Design Method (Dillman, 1979). Each Veteran sampled was sent the questionnaire with a cover letter and return envelope, and a

Demographics

Questionnaires were returned from 114 people, for a 76% response rate. The average age of the respondents was 65 years old, with a range of 24 to 90 years. Almost all of the respondents were male (98%). Many of the Veterans were retired (47%); some were disabled (19%), employed (13%), or unemployed (4%). Most of the Veterans were married (48%), and fewer were widowed (18%), single (18%), or divorced (16%). One respondent was a World War I Veteran, 47 (41%) were World War II Veterans; 24 (21%)

Discussion and conclusion

The WNY VA Pain Survey provided an effective method to obtain information regarding the pain being experienced by a sample of Veterans registered in primary care in WNY. Random selection of the sample and high response rate allow generalizability to the WNY VA’s primary care population, yet small sample size imposes caution. The results of this survey indicated that pain was a widespread phenomenon among Veterans in WNY. Pain, as reflected in the survey, was typically moderate in intensity,

References (32)

  • P. Arnstein et al.

    Self-efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients

    Pain

    (1999)
  • R. Serlin et al.

    When is cancer pain mild, moderate or severe? Grading pain severity by its interference with function

    Pain

    (1995)
  • B. Acello

    Meeting JCAHO standard for pain control

    Nursing 2000

    (2000)
  • American Pain Foundation. (2005). Pain facts: An overview of American pain surveys. Chronic Pain in America: Roadblocks...
  • American Pain Society. (1999). Press Release: New survey of people with chronic pain reveals out-of-control symptoms...
  • American Pain Society. (1998). Chronic pain in America. Roadblock to relief. Archives in Internal Medicine, 158,...
  • Guidelines for treatment of pain

    Journal of the American Medical Association, 274

    (1995)
  • M. Bond et al.

    Why pain control matters in a world full of killer diseases

    Pain Clinical UpdatesInternational Association for the Study of Pain

    (2004)
  • F. Brennan et al.

    Pain relief as a human right

    Pain Clinical UpdatesInternational Association for the Study of Pains

    (2004)
  • Cleeland, C. (1994). Brief pain inventory, short form. Pain Research Group, University of Wisconsin at Madison, In...
  • Pain Management. VHA Directive 2003-021. Washington, DC

    (2003)
  • D. Dillman

    Mail and telephone surveysthe total design method

    (1987)
  • A. Escalante et al.

    Musculoskeletal manifestation of pain and quality of life in Persian Gulf War Veterans referred for rheumatology evaluation

    Journal of Rheumatology

    (1998)
  • K. Foley

    Summary of pain management—overview

    Veterans Health System Journal

    (1999)
  • D. Gordon et al.

    American Pain Society Recommendations for improving the quality of acute and cancer pain management

    Archives of Internal Medicine

    (2005)
  • O. Gureje et al.

    Persistent pain and well beinga WHO study in primary care

    Journal of the American Medical Association

    (1998)
  • Cited by (28)

    View all citing articles on Scopus

    This research was supported by the Veterans Administration Western New York Healthcare System, Health Services Research and Development Special Project.

    The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

    View full text