Pain in elderly patients with knee osteoarthritis: an integrative review of psychosocial factors

Objective: The aim of this integrative review was to identify themes related to psychosocial factors that influence pain in elderly patients with knee osteoarthritis. Methods: Guided by the Whittemore and Knafl (2005) framework for integrative review, studies published in English between 1986 and 2015 were identified using PubMed, Embase, CINAHL, and PsycINFO. The search terms included knee osteoarthritis, elderly, pain and psychosocial factors such as psychology, psychosocial, anxiety, depression, mental health, physiological stress, social support, self-efficacy, pain catastrophizing and psychological distress. Sixteen empirical studies that met eligibility criteria were selected for analysis. Study data were extracted and included in a review matrix. The constant comparative method was then used to develop patterns and themes for the review. Results: Four themes of psychosocial factors influencing pain emerged from the analysis: (a) demographic, (b) disease severity, (c) positive influences and (d) negative influences. Conclusion: This integrative review revealed multiple personal and psychological factors that can influence pain in elderly patients with knee osteoarthritis. Nurses should promote patient education about weight control and coping strategies in order to manage their pain.