Using Q Methodology to Assess Chronic Pain in Elderly Cognitively Intact and Alzheimer's Patients

Abstract

Traditional methods such as visual analogue scales, numeric scales, and questionnaires are often ineffective for evaluating pain in cognitively impaired patients. Alzheimer’s disease is a progressive neurological disorder that alters various cognitive domains including language and speech, resulting in problems with word finding and concentration. There were 23 elderly participants in this Q Methodology stud, 13with mild to moderate Alzheimer’s disease and 10 cognitively intact. Using a 30-card Q set, these individuals were able to communicate about coping with chronic pain. The Q sort process was adapted by individualized explanation and repetition of the condition of instruction. Six uncorrelated factors emerged indicating how all participants described and managed chronic pain. Alzheimer’s patients responded more readily using Q sorts than with traditional pain assessment instruments. Possible explanations for this success are explored and further research options are proposed.