scholarly journals Pain, Depressive Symptoms, and Self-efficacy for Pain Management: Examination in Black Women With Breast Cancer

2021 ◽  
Author(s):  
Jennifer Plumb Vilardaga ◽  
Hannah Fisher ◽  
Joseph Winger ◽  
Shannon Miller ◽  
Christine Nunez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Depressive Symptoms ◽  
Black Women ◽  
Pain Management ◽  
Self Efficacy ◽  
Pain Severity ◽  
Cancer Stage ◽  
College Age ◽  
Assessment And Treatment ◽  
Stage 1

Abstract Purpose: Black women with breast cancer face significant disparities, including high levels of pain. Depressive symptoms and self-efficacy for pain management impact how women with breast cancer manage pain, yet little is known about how these variables relate to pain specifically for Black women with breast cancer. Methods: Baseline regression analyses were conducted using a sample of women (n=98) with stage I-III breast cancer identifying as Black or African-American who were part of a larger intervention trial. Model 1 explored depressive symptoms and pain (i.e., severity and interference). Model 2 explored self-efficacy for pain management and pain. Covariates were age (M=57.22,SD=10.76), cancer stage (50%=stage 1), and education level (36%=some college). Results: Participants reported moderate levels of pain severity and interference. Higher depressive symptoms were related to both higher pain severity and interference; (B=.06, p<.01, 95% CI [.02,.09], β=.32) and (B=.13, p<.001, 95% CI [.09, 17], β=.55) respectively. Likewise, lower self-efficacy for pain management was also related to both higher pain severity and interference; (B=-.04, p<.001, 95% CI [-.05,-.02], β=-.44) and (B=-.06, p<.001, 95% CI [-.08,-.04], β=-.53) respectively. Women reporting less than a high school diploma endorsed significantly higher pain severity and interference than women reporting some college. Age and cancer stage were not significantly related to pain.Conclusion: Pain for Black women with breast cancer may be influenced by depressive symptoms and self-efficacy for pain management, in addition to other important variables. Attending to better assessment and treatment of depressive symptoms and self-efficacy for pain management may improve outcomes.

Breast cancer molecular subtypes association with clinical outcomes and race.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12575-e12575 ◽  
Author(s):  
Ramses F. Sadek ◽  
Li fang Zhang ◽  
Houssein Talal Abdul Sater
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Molecular Subtypes ◽  
Molecular Subtype ◽  
Cancer Stage ◽  
Luminal A ◽  
Luminal B ◽  
Race Disparity

e12575 Background: Breast Cancer (BC) has been classified into four subtypes: Luminal A (LABC), Luminal B (LBBC), Triple negative (TNBC) and HER2-enriched (HER2e). BC mortality in Black women is significantly higher than in Whites and Asians. BC in Blacks has been characterized by higher grade and later stage. Causes of the Black-White BC survival disparity have been investigated, including differences in: diagnostic stage, socioeconomics, and comorbidities. These have led researchers to investigate the differences in tumor molecular subtype and their association with clinical outcomes and races. Methods: This study used the Surveillance, Epidemiology, and End Results – 18 (SEER-18) Registries research data between 2010 and 2013 that included over 212,000 patients. Descriptive statistics, Odds ratios (OR) and 95%Confidence intervals (CI) were used to study the association between BC stage, grade, and mortality and BC molecular subtypes across different races. We employed Cox regression models to explore the race disparity in BC mortality before and after controlling for BC molecular subtype and other clinical and social factors. Results: TNBC had more high grade cancer compared to HER2e subtype (OR, 1.5; CI, 1.3 - 1.8), LBBC (OR, 4.5; CI, 4.0 - 5.0) and LABC (OR, 12.2; CI, 11.2 – 13.3) for Black. BC mortality was higher in TNBC subtype compared to HER2e subtype (OR, 1.3; CI, 1.1 - 1.6), LBBC (OR, 2.4; CI, 2.0 - 2.9), and LABC (OR, 2.8; CI, 2.4 – 3.2) for Blacks. Results are consistent for all races. HER2e subtype had more late cancer stage compare to LBBC (OR, 1.2; CI, 1.0 - 1.4), TNBC (OR, 1.4; CI, 1.2 - 1.6) and LABC (OR, 2.1; CI, 1.8 - 2.4) in Blacks with similar results in all races. BC mortality in Blacks was higher compare with Whites (HR, 1.9; CI, 1.8 - 2.0) and Asian (HR, 2.7; CI, 2.5 - 3.0). After controlling for cancer subtype and other factors in the Cox regression model, the corresponding HRs ware significantly decreased to 1.2 (CI, 1.1 -1.3) and 1.6 (9CI, 1.5 -1.8). Blacks have heighst percent in stage IV and grade higer grade of disease. Conclusions: Molecular subtypes of BC contribute differently to risks of late cancer stage, high cancer grade and BC specific mortality. These differences are consistent in all races. The molecular subtypes and other social and clinical factors may explain part of the BC mortality race disparity.

Prospective study of pain outcomes associated with contralateral prophylactic mastectomy in women with nonhereditary breast cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6587-6587
Author(s):  
Demetria Joy Smith-Graziani ◽  
Patricia A. Parker ◽  
Susan K. Peterson ◽  
Isabelle Bedrosian ◽  
Yu Shen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Repeated Measures ◽  
White Women ◽  
Prophylactic Mastectomy ◽  
Contralateral Prophylactic Mastectomy ◽  
Mean Difference ◽  
Pain Severity ◽  
Pain Outcomes ◽  
Race Ethnicity

6587 Background: Women with nonhereditary breast cancer are increasingly undergoing contralateral prophylactic mastectomy (CPM). We examined pain severity and the impact of pain on the lives of women who underwent CPM compared to those who did not. We also examined the associations between age, race/ethnicity, reconstruction and pain outcomes. Methods: Between 2012 and 2015, we recruited women with newly diagnosed nonhereditary breast cancer who were planned for surgery. We assessed pain with the Brief Pain Inventory at initial surgical consultation and at 1, 6, 12, and 18 months after surgery. The repeated measures model was used to assess the association between pain severity or interference and CPM status over different time points adjusting for other covariates. Results: Of 288 women enrolled (mean age 56 years, 58% non-Hispanic White, 17% non-Hispanic Black), 50 underwent CPM, 163 had unilateral mastectomy, and 75 had breast conserving surgery. Mean pain severity was higher at 1 month (2.78 vs 1.9, p = .01) and 6 months (2.79 vs 1.96, p = .03) after surgery in women with CPM versus those without. In the multivariable repeated measures model adjusted for time, age, race/ethnicity and reconstruction status, there was a significant interaction between time and CPM for pain severity (p < .01) but not interference (p = .13). This suggests that CPM patients had higher pain severity in the first 6 months after surgery, but their pain scores decreased by 12 months becoming similar to women without CPM. Black women had higher pain severity (mean difference 1.35, standard error [SE] 0.35; p < .01) and interference (mean difference 0.91, SE 0.32; p < .01) compared to White women with or without CPM. There was no association between age or reconstruction status and pain severity or interference. Conclusions: Pain severity in patients undergoing CPM is highest during the first 6 months after surgery. Women considering CPM should be counseled about this potential outcome. Race/ethnic disparities exist in pain management, pain perceptions and communication of pain. Black women undergoing breast surgery report worse pain outcomes than White women regardless of CPM status.

scholarly journals Genetic Testing and Surveillance of Young Breast Cancer Survivors and Blood Relatives: A Cluster Randomized Trial

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2526
Author(s):  
Maria C. Katapodi ◽  
Chang Ming ◽  
Laurel L. Northouse ◽  
Sonia A. Duffy ◽  
Debra Duquette ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Genetic Testing ◽  
Black Women ◽  
Cancer Survivors ◽  
Randomized Trial ◽  
Self Efficacy ◽  
Breast Cancer Survivors ◽  
Cluster Randomized Trial ◽  
Cluster Randomized ◽  
Young Breast Cancer

We compared a tailored and a targeted intervention designed to increase genetic testing, clinical breast exam (CBE), and mammography in young breast cancer survivors (YBCS) (diagnosed <45 years old) and their blood relatives. A two-arm cluster randomized trial recruited a random sample of YBCS from the Michigan cancer registry and up to two of their blood relatives. Participants were stratified according to race and randomly assigned as family units to the tailored (n = 637) or the targeted (n = 595) intervention. Approximately 40% of participants were Black. Based on intention-to-treat analyses, YBCS in the tailored arm reported higher self-efficacy for genetic services (p = 0.0205) at 8-months follow-up. Genetic testing increased approximately 5% for YBCS in the tailored and the targeted arm (p ≤ 0.001; p < 0.001) and for Black and White/Other YBCS (p < 0.001; p < 0.001). CBEs and mammograms increased significantly in both arms, 5% for YBCS and 10% for relatives and were similar for Blacks and White/Others. YBCS and relatives needing less support from providers reported significantly higher self-efficacy and intention for genetic testing and surveillance. Black participants reported significantly higher satisfaction and acceptability. Effects of these two low-resource interventions were comparable to previous studies. Materials are suitable for Black women at risk for hereditary breast/ovarian cancer (HBOC).

Pain Self-efficacy Mediates the Relationship Between Depressive Symptoms and Pain Severity

2015 ◽  
Vol 31 (2) ◽  
pp. 137-144 ◽  
Author(s):  
Jay R. Skidmore ◽  
Alex L. Koenig ◽  
Sara J. Dyson ◽  
Amy E. Kupper ◽  
Melissa J. Garner ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Self Efficacy ◽  
Pain Severity ◽  
The Relationship

scholarly journals Managing pain in HIV/AIDS: a therapeutic relationship is as effective as an exercise and education intervention for rural amaXhosa women in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirsty Jackson ◽  
Antonia L. Wadley ◽  
Romy Parker
Keyword(s):  
Depressive Symptoms ◽  
Therapeutic Relationship ◽  
Outcome Measures ◽  
Self Efficacy ◽  
Mixed Model ◽  
Pain Severity ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background Pain is one of the most prevalent symptoms in people living with HIV/AIDS and is largely undermanaged. Both a peer-led exercise and education Positive Living programme (PL programme) and the PL programme workbook alone were previously found to be effective in reducing pain in urban amaXhosa Women Living With HIV/AIDS (WLWHA). A therapeutic relationship was hypothesised to have contributed to the efficacy of both interventions. The aim of the study was to determine the effectiveness of the PL programme and a therapeutic relationship, compared to a therapeutic relationship alone in managing pain amongst rural amaXhosa WLWHA on pain severity and pain interference, and secondary outcomes, symptoms of depression, health-related quality of life (HRQoL) and self-efficacy. Methods In this two-group, single-blind, pragmatic clinical trial with stratified convenience sampling, the PL programme and therapeutic relationship, was compared to a therapeutic relationship alone in rural amaXhosa WLWHA. The PL programme was a 6-week, peer-led intervention comprising education on living well with HIV, exercise and goal setting. The therapeutic relationship comprised follow-up appointments with a caring research assistant. Outcome measures included pain severity and interference (Brief Pain Inventory), depressive symptoms (Beck Depression Inventory), HRQoL (EuroQol 5-Dimensional outcome questionnaire) and self-efficacy (Self-efficacy for Managing Chronic Disease 6-Item Scale). Follow-up was conducted at 4, 8, 12, 24, and 48 weeks. Mixed model regression was used to test the effects of group, time, and group and time interactions of the interventions on outcome measures. Results Forty-nine rural amaXhosa WLWHA participated in the study: PL group n = 26; TR group n = 23. Both intervention groups were similarly effective in significantly reducing pain severity and interference and depressive symptoms, and increasing self-efficacy and HRQoL over the 48 weeks. A clinically important reduction in pain severity of 3.31 points occurred for the sample over the 48 weeks of the study. All of these clinical improvements were obtained despite low and suboptimal attendance for both interventions. Conclusions Providing a therapeutic relationship alone is sufficient for effective pain management amongst rural amaXhosa WLWHA. These findings support greater emphasis on demonstrating care and developing skills to enhance the therapeutic relationship in healthcare professionals working with rural amaXhosa WLWHA. Trial registration PACTR; PACTR201410000902600, 30th October 2014; https://pactr.samrc.ac.za.

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