Pain management and the African American hospice caregiver: a case report.
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ABSTRACT:
SUBMITTER: Baldwin PK
PROVIDER: S-EPMC3640733 | biostudies-literature | 2013 Dec
REPOSITORIES: biostudies-literature
Publications
Pain management and the African American hospice caregiver: a case report.
Baldwin Paula K PK Wittenberg-Lyles Elaine E Kruse Robin L RL Demiris George G Parker Oliver Debra D
The American journal of hospice & palliative care 20121210 8
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Project description:PurposeAfrican-American women with breast cancer face significant disparities, including high levels of pain. Depressive symptoms and self-efficacy for pain management impact how women with breast cancer manage pain, yet little is known about how these variables relate to pain specifically for African-American women with breast cancer.MethodsBaseline linear regression analyses were conducted using a sample of women (n = 98) with stage I-III breast cancer identifying as Black or African-American who were part of a larger intervention trial. Linear regressions explored the effect of depressive symptoms on pain (i.e., severity and interference), and the effect of self-efficacy for pain management on pain. Covariates were age (M = 57.22, SD = 10.76), cancer stage (50% = stage 1), and education level (36% = some college).ResultsParticipants reported moderate levels of pain severity and interference. Higher depressive symptoms were related to both higher pain severity and interference; (B = 0.06, p < 0.01, 95% CI [0.02,0.09]) and (B = 0.13, p < 0.001, 95% CI [0.09, 0.17]) respectively. Likewise, lower self-efficacy for pain management was also related to both higher pain severity and interference; (B = - 0.04, p < 0.001, 95% CI [- 0.05, - 0.02]) and (B = - 0.06, p < 0.001, 95% CI [- 0.08, - 0.04]) respectively. Women reporting less than a high school diploma endorsed significantly higher pain severity and interference than women reporting some college. Age and cancer stage were not significantly related to pain.ConclusionPain for African-American women with breast cancer may be influenced by depressive symptoms and self-efficacy for pain management, in addition to other important variables. Attending to better assessment and treatment of depressive symptoms and self-efficacy for pain management may improve outcomes.
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Project description:ObjectiveTo explore and describe older African Americans' patterns and perceptions of managing chronic osteoarthritis pain.MethodsA convergent parallel mixed-methods design incorporating cross-sectional surveys and individual, semistructured interviews.SettingOne hundred ten African Americans (≥50 years of age) with clinical osteoarthritis (OA) or provider-diagnosed OA from communities in northern Louisiana were enrolled.ResultsAlthough frequency varied depending on the severity of pain, older African Americans actively used an average of seven to eight self-management strategies over the course of a month to control pain. The average number of self-management strategies between high and low education and literacy groups was not statistically different, but higher-educated adults used approximately one additional strategy than those with high school or less. To achieve pain relief, African Americans relied on 10 self-management strategies that were inexpensive, easy to use and access, and generally perceived as helpful: over-the-counter (OTC) topicals, thermal modalities, land-based exercise, spiritual activities, OTC and prescribed analgesics, orthotic and assistive devices, joint injections, rest, and massage and vitamins.ConclusionsThis is one of the first studies to quantitatively and qualitatively investigate the self-management of chronic OA pain in an older African American population that happened to be a predominantly higher-educated and health-literate sample. Findings indicate that Southern-dwelling African Americans are highly engaged in a range of different self-management strategies, many of which are self-initiated. Although still an important component of chronic pain self-management, spirituality was used by less than half of African Americans, but use of oral nonsteroidal anti-inflammatory drugs and opioids was relatively high.
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Project description:Although very little is known about African American cancer patients' pain experience, a few studies have indicated that their cancer pain experience is unique and somewhat different from that of other ethnic groups. The purpose of the study reported in this article was to explore African American cancer patients' pain experience using an online forum. This study was a qualitative online forum designed from a feminist perspective and conducted among 11 African American cancer patients who were recruited through both Internet and real settings. Nine online forum topics were used to administer the 6-month online forum, and the data were analyzed using thematic analysis. Four themes emerged through the data analysis process. First, participants viewed cancer as a challenge in life that they should fight against. Second, cancer pain was differentiated from ordinary pain because cancer was stigmatized in their culture. Third, participants viewed that African Americans, especially women, were culturally raised to be strong, and this African American cultural heritage inhibited cancer patients from expressing pain and seeking help for pain management. Finally, the findings indicated certain changes in perspectives among African American cancer patients during the disease process, which might make them tolerate pain through praying to God and reading the Bible. Based on the findings, we suggest further studies among diverse groups of African American cancer patients, with a focus on cultural attitudes toward cancer pain and influences of family on cancer pain experience.
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Project description:Caregiver-adolescent communication about sex plays a critical role in the sexual socialization of youth. Many caregivers, however, do not engage their youth in such conversations, potentially placing them at risk for negative sexual health outcomes. Lack of caregiver-adolescent communication about sex may be particularly harmful for rural African American youth, as they often report early sex initiation and are disproportionately impacted by STIs. Moreover, sexual communication may be particularly challenging for families with strong religious backgrounds, potentially affecting the occurrence and breadth of topics covered during communication. Study aims were to: determine whether there was a relationship between caregiver religiosity and type of topics covered during communication about sex (e.g., general sexual health vs. positive aspects of sexuality) among 435 caregivers of early adolescent, African American youth; and if so, identify factors that might explain how religiosity affects communication about sex. Results indicated that caregiver religiosity was positively associated with communication about general, but not positive aspects of sexuality for caregivers of males. Attitudes towards communication about sex and open communication style mediated the relationship. There was no association between religiosity and communication about sex for caregivers of females. The findings from this study could provide a base to better understand and support the sexual socialization process within religious, African American families.
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2020-03-27 | GSE147628 | GEO