The role of everyday emotion regulation on pain in hospitalized elderly:: Insights from a prospective within-day assessment

Pain management is still an unresolved issue among the general elderly patient population in institutions. It is proposed that everyday emotion regulation (i.e. self-supporting maintenance or change in positive and negative emotions) performed by hospitalized elderly can help reduce pain intensity. This argument is based on (1) robust evidence in life span research of elderly's high ability for emotion regulation in the midst of everyday life and (2) experimental evidence from pain research that simple strategies to regulate emotions impact pain intensity. A prospective within-day study was designed to (1) empirically trace the occurrence of emotion regulation over specific sampling episodes, (2) assess the impact of this regulation on end-of-episode pain intensity. and (3) consider the effects of socio-demographic, psychological, and clinical factors on emotion regulation and its relationship to pain intensity. Thirty patients (mean age 78.8) of a geriatric facility provided ratings of emotional states and pain intensity. Emotion regulation was defined as maintenance/recovery of desirable emotional states and computed for individual emotions (positive feelings, anger, anxiety, and mild depressed feelings) and globally to reflect the number of emotions successfully regulated. Multilevel analyses found emotion regulation to be prospectively related to pain intensity, for both global and anxiety regulation. While this relationship held across the sample, lower emotion regulation was found for old-old (vs. young-old), males (vs. females), and patients living alone (vs. with others). Results suggest the possibility that promoting emotion regulation as self-management strategy could contribute to cost-effective pain management in general or targeted elderly populations. (c) 2005 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.