Barriers to Pain Management: Incongruence in Black Cancer Caregiving Dyads.

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Tytuł:: Barriers to Pain Management: Incongruence in Black Cancer Caregiving Dyads.
Autorzy:: Bonds Johnson K; Nell Hodgson Woodruff School of Nursing (K.B.J., J.B., D.W., S.P., H.L., K.A.Y.), Emory University, Atlanta, Georgia, USA.. Electronic address: .
Bai J; Nell Hodgson Woodruff School of Nursing (K.B.J., J.B., D.W., S.P., H.L., K.A.Y.), Emory University, Atlanta, Georgia, USA.; Winship Cancer Institute (J.B., K.A.Y.),, Emory University, Atlanta, Georgia, USA.
Waldrop D; Nell Hodgson Woodruff School of Nursing (K.B.J., J.B., D.W., S.P., H.L., K.A.Y.), Emory University, Atlanta, Georgia, USA.
Paul S; Nell Hodgson Woodruff School of Nursing (K.B.J., J.B., D.W., S.P., H.L., K.A.Y.), Emory University, Atlanta, Georgia, USA.
Lee H; Nell Hodgson Woodruff School of Nursing (K.B.J., J.B., D.W., S.P., H.L., K.A.Y.), Emory University, Atlanta, Georgia, USA.
Lyons KS; Connell School of Nursing (K.S.L.), Boston College, Chestnut Hill, Massachusetts, USA.
Yeager KA; Nell Hodgson Woodruff School of Nursing (K.B.J., J.B., D.W., S.P., H.L., K.A.Y.), Emory University, Atlanta, Georgia, USA.; Winship Cancer Institute (J.B., K.A.Y.),, Emory University, Atlanta, Georgia, USA.
Źródło:: Journal of pain and symptom management [J Pain Symptom Manage] 2022 May; Vol. 63 (5), pp. 711-720. Date of Electronic Publication: 2022 Jan 04.
Typ publikacji:: Journal Article; Research Support, N.I.H., Extramural
Język:: English
Imprint Name(s):: Publication: New York, NY : Elsevier
Original Publication: [Madison, WI : Dept. of Anesthesiology, University of Wisconsin--Madison, 1986-
MeSH Terms:: Caregivers*
Neoplasms*/therapy
Humans ; Pain ; Surveys and Questionnaires
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Grant Information:: P30 NR014134 United States NR NINR NIH HHS; T32 NR012715 United States NR NINR NIH HHS
Contributed Indexing:: Keywords: African American; Cancer pain; adherence; black American; black race; caregivers; opioids
Entry Date(s):: Date Created: 20220107 Date Completed: 20220418 Latest Revision: 20230502
Update Code:: 20240104
PubMed Central ID:: PMC9018523
DOI:: 10.1016/j.jpainsymman.2021.12.033
PMID:: 34995683
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Context: To effectively manage cancer pain, there is a need to understand how caregiving dyads appraise symptoms. Dyadic appraisal of symptoms influences whether the dyad perceives the patient's pain is managed well and whether they are on the same page with their appraisal. Beliefs can act as barriers to the dyadic appraisal.
Objectives: This secondary data analysis examined incongruence within Black cancer caregiving dyads regarding beliefs about pain management and potential medication side effects using the Barriers Questionnaire-13. Associated factors were also examined.
Methods: Guided by the Theory of Dyadic Illness Management, dyadic multilevel modeling was conducted with data from 60 Black cancer caregiving dyads to determine the dyadic appraisal of beliefs about pain management and potential medication side effects, which includes the average perception of barriers within the dyad (i.e., dyadic average) and the dyadic incongruence (i.e., gap between patient and caregiver).
Results: On average, Black cancer caregiving dyads reported moderate barriers regarding pain management (2.262 (SE=0.102, P<0.001) and medication side effects (2.223 (SE=0.144, P<0.001). There was significant variability across dyads regarding barriers to pain management and medication side effects. Lower patient education and higher patient-reported pain interference were significantly associated with more perceived barriers to pain management and potential medication side effects. Incongruence within dyads regarding barriers to pain management and medication side effects were significantly associated with the caregiver's report of patient's pain interference.
Conclusion: Findings suggest the importance of appraisal that includes both members of Black cancer caregiving dyads regarding pain management.
(Copyright © 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

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