Well-being of Veterans with chronic pain with fewer activities limited by pain: Life After Service Studies 2019 survey

LAY SUMMARY This study aimed to understand how common chronic pain is among Canadian Armed Forces (CAF) Veterans and the characteristics that were related with having fewer activities limited by pain using the Life After Service Studies (LASS) 2019 survey. The LASS survey was a Statistics Canada telephone survey of CAF Veterans released in 1998-2018. About 1 in 2 (50.7%) reported living with chronic pain. CAF Veterans between 50 and 59 years who were female, employed, had higher education, higher rank, longer length of service, or higher income had fewer activities limited by chronic pain. High levels of mastery (feeling in control of factors affecting one's life) was linked to having fewer activities limited by pain among people with moderate to severe pain. The strong link between higher mastery and fewer activities limited by pain points to a need for pain management supports addressing aspects of CAF Veterans' well-being beyond pain severity and physical health. Introduction: There is considerable variance in the relationship between pain severity and activities limited by pain in Canadian Armed Forces (CAF) Veterans. It is possible those who reported fewer activities with pain may be doing better in certain well-being domains. Understanding these relationships may guide future research and clinical care. This article reports the prevalence of chronic pain in CAF Veterans, describes their characteristics, and identifies well-being indicators associated with fewer activities limited by pain. Methods: The Life After Service Studies (LASS) 2019 survey was a Statistics Canada cross-sectional, computer-assisted telephone interview survey of the well-being of CAF Regular Force Veterans released in 1998-2018. Data were analyzed using descriptive analysis and ordinal logistic regression modelling. Results: There were 1,222 Veterans who reported living with chronic pain, with a prevalence of 50.7% (95% CI, 48.0-53.4). Those with moderate or severe pain who reported no or few activities limited by pain were more likely to be ages 50-59 years, female, and employed, and more likely to have higher education, higher rank, longer length of service, or higher income adequacy. They were also more likely to be satisfied with family, main activities, or finances. Regression modelling in those with moderate to severe pain demonstrated those with fewer activities limited by pain were less likely to have low mastery (unadjusted odds ratio 18.5; 95% CI, 8.0-42.6). Discussion: The strong association between a sense of mastery and fewer activities limited by pain provides important avenues for future research.