Psycho-sociocultural factors influencing cancer pain management in elderly adults

流行病学证据表明，老年少数族裔成年人患癌症疼痛的可能性较小 被记录的癌症疼痛被误诊和治疗不足的风险增加，并报告 他们的疼痛较少得到缓解或止痛治疗。该项目分为两个阶段，描述性调查和 一种教育疼痛管理干预措施，以评估这种差异是否受到已识别的 社会、文化或心理结构。第一阶段(描述性)的主要目标是阐明 现有的社会、文化和心理来源可能会影响癌症疼痛的体验， 老年黑人和白人对癌症疼痛护理和管理的满意度 乳腺癌或前列腺癌。支持这一目标的目的是：1)评估老年黑人和 白人癌症患者在社会(歧视)、文化(文化遗产、种族认同)和 心理(抑郁、医生不信任、症状苦恼)变量，并确定这些因素 作为解释不同健康结果的潜在调解人，2)确定 确定的心理社会和文化因素，以及3)评估拟议的理论模型在 解释种族群体内部和种族之间已识别的健康结果变量的个体差异 老年癌症患者的比例。在第一阶段概念模型的指导下，第二阶段(干预)的目标是 目的：1)确定癌症疼痛管理教育干预的可行性和可接受性 老年黑白癌症患者，以及2)评估患者对治疗的反应和满意度 计划，同时确定潜在的心理、社会和文化结构，这些结构是阻碍 有效的疼痛管理。到目前为止，我们还没有确定任何研究检查了所确定的影响 心理社会和文化因素(例如，歧视、种族认同)对最佳癌症疼痛有影响 管理层。此外，很少有干预措施旨在解决这些结构，因为它们与 老年人癌症疼痛的护理和管理。研究这些因素将被证明是 有可能缩小差距，消除癌症疼痛护理和管理方面的障碍。

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.