The main goal of the proposed SC3 research is to improve the rigor of our laboratory?s current SC3 research on pain in mainly low-income older women. We will collect a sample of the same size and ethnic composition as that of the current grant, but will use a mixed method approach. This will allow us to go beyond the mere quantification of pain intensity -- which is a typical shortcoming of most of the pain literature -- by studying pain context factors both qualitatively and quantitatively. The outcomes of this research will help fill a gap in the ethnogeriatric literature. Management of pain in older age is a major health challenge that is a top NIH research priority. This is especially the case regarding pain care disparities, which NIH has urged to investigate a) within specific racial and ethnic groups as well as b) among older adults (Institute of Medicine, 2011), as we plan on doing in this study. Innovatively, we developed our own questions to best measure pain context factors via both open-ended qualitative and Likert-type scale items. Some of them were adapted by the PI from the classic Substance Abuse and Mental Health Services Administration?s (2004) guidelines on best practices for pain assessment and pain medication treatment, undertreatment, and overtreatment. In addition to being based on a review of the literature, other items were based on the PI?s in-person consultations with the American Pain Society?s former president and with medical doctors and nurses belonging to this professional organization. Using the empirically-supported inclusion criterion of experiencing pain within the past 4 weeks, we plan to: create pain profiles based on the entire sample (N=300), with 100 African-American, 100 Hispanic-American, and 100 European-American older women in Aim 1; identify ethnicity-specific pain profile differences, find ethnicity-specific reasons for these differences, and create ethnicity-specific pain profiles in Aim 2; as well as investigate the relationship of ethnicity-specific pain profiles with empirically validated pain-related quantitative variables in Aim 3. Measurements will include: a demographics list, a well-established and medically-focused pain questionnaire, the aforementioned new pool of pain context items, as well as quantitative measures of daily minor cognitive failures, non-medical stress, PTSD symptomatology, and depressive symptomatology.
This project covers many issues of critical importance to a more in-depth understanding of the pain experience and pain management among different ethnic groups of older women, going beyond the simple quantification of pain in terms of its intensity, which is a shortcoming of most of the published pain research. Identifying pain profiles in our under-studied population would contribute to fundamental knowledge about questions not yet answered in the literature, such as whether older women?s pain experience and management differ by ethnicity and are related to pain-relevant cognitive and psychopathological factors. Applying this study?s results and broad conclusions could decrease pain symptomatology as well as reduce illness and disability, revealing time-saving ways to conceptualize and assess pain in a more in-depth and culturally sensitive fashion. Healthcare providers working in often-frantic medical settings could use this knowledge to quickly identify critical pain context factors that are most applicable to their patients and to minimize pain undertreatment or risky overtreatment.
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