Influence of Social and Health Indicators on Pain Interference With Everyday Activities Among Older Black and White Cancer Patients

OBJECTIVE: This prospective study aimed to determine the influence social and health factors have on pain interference with everyday activities among older patients receiving outpatient treatment services from a comprehensive cancer center. METHOD: Participants were surveyed on questions assessing pain interference, and social (communication), health (pain severity, comorbidities), behavioral (self-efficacy, affect), and demographic characteristics. Multivariate analyses were specified to examine determinants of pain interference, with items loading on separate cluster composites: physical interference and psychosocial interference. RESULTS: Pain severity was a significant indicator for physical interference. Similarly, pain severity, education, self-efficacy, negative affect, and communication were predictors of psychosocial interference. DISCUSSION: Factors defining the daily lived experiences of older adults are important in providing baseline information on functional status. This emphasizes the need to rigorously examine the association between pain, and clinical and psychosocial indicators, but more importantly indicators that contribute to the patient’s ability to perform normal everyday activities

Distributed Cognition in Cancer Treatment Decision Making: An Application of the DECIDE Decision-Making Styles Typology

Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients (N = 46). Analysis of transcript data yielded empirical support for four distinct models of health decision making. The implications of these findings for developing interventions to improve the quality of treatment decision making and overall well-being are discussed

Distributed Cognition in Cancer Treatment Decision Making: An Application of the DECIDE Decision-Making Styles Typology

Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients (N = 46). Analysis of transcript data yielded empirical support for four distinct models of health decision making. The implications of these findings for developing interventions to improve the quality of treatment decision making and overall well-being are discussed

Characterizing Community Health Workers on Research Teams: Results From the Centers for Population Health and Health Disparities

Objectives. To quantify the characteristics of community health workers (CHWs) involved in community intervention research and, in particular, to characterize their job titles, roles, and responsibilities; recruitment and compensation; and training and supervision

The Conceptualization of Self-Identity among Residents of Appalachia Ohio

Social identity and its association to culture, place, and health is an important, but understudied, area of research. One social group that illustrates this connection between place and identity is people living in Appalachia. This exploratory mixed-method study investigates the appropriateness of the self-concept of Ohio Appalachian adults with cancer as “Appalachian,” the context associated with that identity and its association with community identification, rural identity, Appalachian Regional Commission (ARC) status, demographic data, and clinical trial (CT) enrollment. Forty-nine adults with cancer residing in Appalachia were recruited. Participants were cancer patients who (1) were offered a randomized clinical cancer trial; and (2) lived in or were treated in one of the thirty-two rural Appalachian counties in Ohio. Forty-seven percent of participants identified themselves as Appalachian and were reluctant to self-identify as Appalachian because of negative stereotypes or uncertainty about the term. Furthermore, many participants endorsed their residence within Appalachia but not their own identity. Future studies should utilize a culturally grounded approach and community-based methodology to explore how residents of Appalachian communities define their community and self-identification in order to improve health in the region

Identifying factors of psychological distress on the experience of pain and symptom management among cancer patients

Abstract Background Epidemiological evidence suggests the impact psychological distress has on symptomatic outcomes (pain) among cancer patients. While studies have examined distress across various medical illnesses, few have examined the relationship of psychological distress and pain among patients diagnosed with cancer. This study aimed to examine the impact psychological distress-related symptoms has on pain frequency, presence of pain, and pain-related distress among oncology patients. Methods Data were collected from a sample of White and Black adults (N = 232) receiving outpatient services from a comprehensive cancer center. Participants were surveyed on questions assessing psychological distress (i.e., worry, feeling sad, difficulty sleeping), and health (pain presence, pain frequency, comorbidities, physical functioning), behavioral (pain-related distress), and demographic characteristics. Results Patients reporting functional limitations were more likely to report pain. Specifically, those reporting difficulty sleeping and feeling irritable were similarly likely to report pain. Data further showed age and feeling irritable as significant indicators of pain-related distress, with younger adults reporting more distress. Conclusions It must be recognized that psychological distress and experiences of pain frequency are contingent upon a myriad of factors that are not exclusive, but rather coexisting determinants of health. Further assessment of identified predictors such as age, race, socioeconomic status, and other physical and behavioral indicators are necessary, thus allowing for an expansive understanding of the daily challenges and concerns of individuals diagnosed with cancer, while providing the resources for clinicians, researchers, and policy makers to better meet the needs of this patient population

The Influence of Pain Severity and Interference on Satisfaction with Pain Management among Middle-Aged and Older Adults

Background. Health outcomes are often contingent on how effective the individual is able to manage existent illness-related symptoms. This is all the more relevant among chronic pain patients. Objective. This study aimed to identify indicators of pain treatment satisfaction among middle-aged and older adults (N=150) receiving outpatient treatment from a comprehensive cancer center. Methods. Patients were surveyed on questions assessing pain treatment satisfaction, pain severity, and additional social characteristics. Results. Descriptive data showed that middle-aged adults reported more pain locations, greater pain severity, and less satisfaction with pain treatment. A multivariate model was specified, showing older adults being more satisfied with their pain treatment. For the middle-aged adults, treatment satisfaction was generally lower with greater pain severity. This counters that for the older adults, where treatment satisfaction remained consistent despite increased levels of pain severity. Conclusion. These findings address an important issue regarding how pain is experienced across the life course. This suggests that general assumptions cannot be made about the health outcomes of older adults. Beyond the descriptive definitions of pain, there remains the need to develop models that account for determinants that may account for the pain experience among a diverse adult population