(from applicant): 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.
