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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

基本信息

批准号：
8515750
负责人：
Tamara A Baker
金额：
$ 14.01万
依托单位：
UNIVERSITY OF SOUTH FLORIDA
依托单位国家：
美国
项目类别：
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/8515750
关键词：
Address Adult Age Analgesics Cancer Pain Management Cancer Patient Caring Colon Carcinoma Colorectal Cancer Data Diagnosis Disease Distress Economics Educational Intervention Educational Materials Effectiveness Elderly Epidemiology Evaluation Gender Goals Health Individual Differences Instruction Intervention Knowledge Mails Malignant Neoplasms Malignant neoplasm of lung Malignant neoplasm of prostate Measures Mediating Mediator of activation protein Mental Depression Minority Modeling Outcome Pain Pain Measurement Pain intensity Pain management Participant Patients Perception Phase Physicians Population Prevalence Psychological Factors Quality of life Race Reaction Reporting Research Research Design Research Methodology Risk Sampling Self Efficacy Social Discrimination Social support Source Surveys Symptoms Theoretical model base cancer pain cancer therapy ethnic discrimination experience health disparity intervention program malignant breast neoplasm older patient post intervention programs psychologic psychosocial racial difference racism satisfaction social therapy design

项目摘要

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.

流行病学证据表明，老年少数民族成年人不太可能有他们的癌症疼痛记录，在增加的风险误诊和治疗不足的癌症疼痛，并报告较少的缓解或止痛治疗。该项目提出两个阶段，一个是描述性调查，教育性疼痛管理干预，以评估这种差异是否受到已确定的社会、文化或心理结构。阶段I（描述性）的主要目的是阐明可能影响癌痛体验的现有社会、文化和心理来源，老年黑人和白人癌症疼痛护理和管理的满意度诊断为肺，结肠，乳腺癌或前列腺癌。支持这一目标的目的是：1）评估老年黑人和白色癌症患者在社会（歧视，SES），文化（文化遗产，种族认同），心理（抑郁，医生不信任，症状困扰）变量，并确定这些因素是否作为解释不同健康结果的潜在媒介，2）确定确定的社会心理和文化因素，3）评估所提出的理论模型的效用，解释种族群体内和种族群体间已确定的健康结果变量的个体差异老年癌症患者。在第一阶段概念模式的指导下，第二阶段（干预）的目标是 1）确定癌症疼痛管理教育干预的可行性和可接受性，老年黑人和白色癌症患者，以及2）评估患者对计划，同时确定潜在的心理，社会和文化结构，目前作为障碍，有效的疼痛管理。到目前为止，我们还没有发现任何研究已经确定的影响，心理社会和文化因素（例如，歧视，种族认同）对最佳癌症疼痛管理此外，很少有干预措施旨在解决这些概念，因为它们与老年人癌痛的护理和管理。研究这些因素将证明是关键，潜在地减少差异并消除癌症疼痛护理和管理的障碍。