Kalisha Bonds Johnson1, Jinbing Bai2, Drenna Waldrop3, Sudeshna Paul3, Haerim Lee3, Karen S Lyons4, Katherine A Yeager2. 1. 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: kalisha.bonds@emory.edu. 2. 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. 3. 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. 4. Connell School of Nursing (K.S.L.), Boston College, Chestnut Hill, Massachusetts, USA.
Abstract
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.
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.
Authors: Keith E Whitfield; Jason C Allaire; Rhonda Belue; Christopher L Edwards Journal: J Gerontol B Psychol Sci Soc Sci Date: 2008-09 Impact factor: 4.077