Psycho-sociocultural factors influencing cancer pain management in elderly adults

影响老年人癌症疼痛管理的心理社会文化因素

• 批准号: 7586886
• 负责人: Tamara A Baker
• 金额: $ 13.09万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-25 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7586886
• 关键词: Address; Adult; Affect; Analgesics; Arthritis; Benign; Breast; Cancer Pain Management; Cancer Patient; Caring; Colon; Critiques; Data; Diagnosis; Disease; Distress; Economics; Educational Intervention; Elderly; Epidemiology; Equation; Etiology; Florida; Foundations; Gender; Goals; Grant; Health; Individual Differences; Intervention; Investigation; K-Series Research Career Programs; Knowledge; Learning; Literature; Lung; Mails; Malignant Neoplasms; Malignant neoplasm of prostate; Mediator of activation protein; Methods; Minority; Modeling; Outcome; Pain; Pain Measurement; Pain management; Patients; Phase; Physicians; Population; Prevalence; Principal Investigator; Protocols documentation; Psychological Factors; Published Comment; Race; Reaction; Reporting; Research; Research Design; Risk; Social Discrimination; Source; Supervision; Surveys; Symptoms; Theoretical model; Training; Travel; Universities; Visit; Work; base; cancer pain; cancer therapy; career; career development; depression; design; ethnic discrimination; experience; health disparity; interest; programs; psychologic; psychosocial; racism; response; satisfaction; social; symptom management; therapy design

DESCRIPTION (from applicant): Epidemiological evidence shows that elderly minority adults are less likely to have their cancer pain recorded, are at an increased risk for the misdiagnosis and under-treatment of their cancer pain, and report less relief or analgesic treatment for their pain. This project proposes two phases, a descriptive survey and an educational pain management intervention, to assess if such disparities are influenced by identified social, cultural, or psychological constructs. The primary objective for phase I (descriptive) is to elucidate existing social, cultural, and psychological sources that may influence the experience of cancer pain, satisfaction with cancer pain care and management in elderly Blacks and Whites diagnosed with lung, colon, breast, or prostate cancer. The aims to support this objective are to: 1) assess whether elderly Black and White cancer patients differ in social (discrimination, SES), cultural (cultural heritage, ethnic identity), and psychological (depression, physician mistrust, symptom distress) variables, and to determine if these factors serve as potential mediators explaining differential health outcomes, 2) determine the relationship between identified psychosocial and cultural factors, and 3) assess the utility of a proposed theoretical model in explaining individual differences in identified health outcome variables both within and between race groups of elderly cancer patients. Guided by phase I's conceptual model, the objective for phase II (intervention) is to: 1) determine the feasibility and acceptability of a cancer pain management education intervention among elderly Black and White cancer patients, and 2) evaluate patients' reactions to and satisfaction with the program, while identifying potential psychological, social, and cultural constructs that present as barriers to effective pain management. To date, we have identified no studies that have examined the impact identified psychosocial and cultural factors (e.g., discrimination, ethnic identity) have on optimal cancer pain management. In addition, there are few interventions designed to address these constructs as they relate to cancer pain care and management among the elderly. Examining these factors will prove pivotal in potentially reducing disparities and eliminating barriers to cancer pain care and management.

描述（来自申请人）：流行病学证据表明，少数族裔成年人不太可能记录其癌症疼痛，对癌症疼痛的误诊和治疗不足的风险增加，并且报告疼痛的缓解或止痛治疗较少。该项目提出了两个阶段，即描述性调查和教育疼痛管理干预措施，以评估这种差异是否受到确定的社会，文化或心理结构的影响。第一阶段（描述性）的主要目标是阐明可能影响癌症疼痛的经历，对癌症疼痛护理的经历，对癌症疼痛护理的满意度以及被诊断为肺，结肠，乳腺癌或前列腺癌的白人的满意度。支持这一目标的目的是：1）评估老年人黑人和白人癌症患者在社会（歧视，SES），文化（文化遗产，种族认同）和心理学（抑郁，医师的不信任，症状困扰）变量的社会（文化遗产，种族认同）方面是否有所不同，并确定这些因素是确定的，并确定了对差异的影响，并确定了对差异的影响，2）理论模型解释了鉴定出的健康结果变量的个体差异，包括老年癌症患者的种族组。在第一阶段的概念模型的指导下，II期（干预）的目标是：1）确定老年黑人和白人癌症患者的癌症疼痛管理教育干预的可行性和可接受性，以及2）评估患者对该计划的反应和满足，同时确定潜在的心理，社会和文化结构，这些结构是有效疼痛管理的障碍。迄今为止，我们尚未确定研究的研究已经检查了确定的心理和文化因素（例如歧视，种族认同）对最佳癌症疼痛管理具有的影响。此外，很少有干预措施旨在解决这些结构，因为它们与老年人之间的癌症疼痛护理和管理有关。检查这些因素将证明在潜在地减少差异并消除癌症疼痛护理和管理的障碍方面是关键的。