scholarly journals Patterns and Perceptions of Self-Management for Osteoarthritis Pain in African American Older Adults

Pain Medicine ◽  
2018 ◽  
Vol 20 (8) ◽  
pp. 1489-1499 ◽  
Author(s):  
Staja Booker ◽  
Keela Herr ◽  
Toni Tripp-Reimer

AbstractObjectiveTo explore and describe older African Americans’ patterns and perceptions of managing chronic osteoarthritis pain.MethodsA convergent parallel mixed-methods design incorporating cross-sectional surveys and individual, semistructured interviews.SettingOne hundred ten African Americans (≥50 years of age) with clinical osteoarthritis (OA) or provider-diagnosed OA from communities in northern Louisiana were enrolled.ResultsAlthough frequency varied depending on the severity of pain, older African Americans actively used an average of seven to eight self-management strategies over the course of a month to control pain. The average number of self-management strategies between high and low education and literacy groups was not statistically different, but higher-educated adults used approximately one additional strategy than those with high school or less. To achieve pain relief, African Americans relied on 10 self-management strategies that were inexpensive, easy to use and access, and generally perceived as helpful: over-the-counter (OTC) topicals, thermal modalities, land-based exercise, spiritual activities, OTC and prescribed analgesics, orthotic and assistive devices, joint injections, rest, and massage and vitamins.ConclusionsThis is one of the first studies to quantitatively and qualitatively investigate the self-management of chronic OA pain in an older African American population that happened to be a predominantly higher-educated and health-literate sample. Findings indicate that Southern-dwelling African Americans are highly engaged in a range of different self-management strategies, many of which are self-initiated. Although still an important component of chronic pain self-management, spirituality was used by less than half of African Americans, but use of oral nonsteroidal anti-inflammatory drugs and opioids was relatively high.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S70-S70
Author(s):  
Staja Booker ◽  
Keela Herr ◽  
Toni Tripp-Reimer

Abstract Self-management support from family, friends, and providers is a crucial element in controlling osteoarthritis pain. 110 African-Americans (50-94 years) were surveyed regarding social and provider self-management support, and 18 of the African-American participants were also individually interviewed. This mixed-methods analysis unveiled that 77% were not receiving familial/social or provider support, and a conventional qualitative content analysis confirmed the lack of expected support for self-management with sentiments such as “I’m doin’ this all on my own.” Nonetheless, older African-Americans respected providers’ professional opinion, and 82% believed that treatment from a provider would be helpful. They desired more education and treatment options because they “need somebody to help with these joints and muscles”. However, participants were forced to learn how to care for osteoarthritis pain: “I was taking pain medication, but when I went to the doctor last time he told me to stop… Told me to deal with it [pain].”


2021 ◽  
Author(s):  
Nwanyieze Ngozi Jiakponnah ◽  
Christine Unson ◽  
Queendaleen Chinenye Chukwurah

Abstract Background and Objectives This study investigated the behavioral and psychological correlates of strength and balance training (SBT) participation among older African Americans. Research Design and Methods A cross-sectional survey of 90 older African Americans (M = 66.7 ± 8.7 years; 70% female) was conducted to assess correlates of intention to undertake SBT exercises and the number of days that they currently engage in SBT. The Theory of Planned Behavior (TPB) and the threat appraisal of the Protection Motivation Theory (PMT) were used as frameworks for the analyses. Results The intention to do SBT exercises was positively associated with favorable attitudes and subjective norm, knowledge about the benefits of SBT, and hours worked per week. The frequency of SBT participation was significantly correlated with behavioral intention, high fear of falling, and a low score on the kinesiophobia scale. Discussion and Implications This study demonstrated the utility of the TPB and PMT’s threat appraisal construct in modeling intention and number of days of SBT participation among African American older adults. The study affirmed the link between intention and behavior and between knowledge of the benefits of SBT and intention. Fear of falling’s positive association with days of SBT suggests that respondents’ saw SBT’s efficacy in reducing falls. The unique contributions of this study are the inclusions of kinesiophobia as a correlate and multiple threat appraisals in the PMT. Health promotion interventions should consider the interrelationship among these constructs.


2020 ◽  
Vol 11 (05) ◽  
pp. 769-784
Author(s):  
Ipek Ensari ◽  
Adrienne Pichon ◽  
Sharon Lipsky-Gorman ◽  
Suzanne Bakken ◽  
Noémie Elhadad

Abstract Background Self-tracking through mobile health technology can augment the electronic health record (EHR) as an additional data source by providing direct patient input. This can be particularly useful in the context of enigmatic diseases and further promote patient engagement. Objectives This study aimed to investigate the additional information that can be gained through direct patient input on poorly understood diseases, beyond what is already documented in the EHR. Methods This was an observational study including two samples with a clinically confirmed endometriosis diagnosis. We analyzed data from 6,925 women with endometriosis using a research app for tracking endometriosis to assess prevalence of self-reported pain problems, between- and within-person variability in pain over time, endometriosis-affected tasks of daily function, and self-management strategies. We analyzed data from 4,389 patients identified through a large metropolitan hospital EHR to compare pain problems with the self-tracking app and to identify unique data elements that can be contributed via patient self-tracking. Results Pelvic pain was the most prevalent problem in the self-tracking sample (57.3%), followed by gastrointestinal-related (55.9%) and lower back (49.2%) pain. Unique problems that were captured by self-tracking included pain in ovaries (43.7%) and uterus (37.2%). Pain experience was highly variable both across and within participants over time. Within-person variation accounted for 58% of the total variance in pain scores, and was large in magnitude, based on the ratio of within- to between-person variability (0.92) and the intraclass correlation (0.42). Work was the most affected daily function task (49%), and there was significant within- and between-person variability in self-management effectiveness. Prevalence rates in the EHR were significantly lower, with abdominal pain being the most prevalent (36.5%). Conclusion For enigmatic diseases, patient self-tracking as an additional data source complementary to EHR can enable learning from the patient to more accurately and comprehensively evaluate patient health history and status.


2007 ◽  
Vol 101 (3_suppl) ◽  
pp. 1133-1140 ◽  
Author(s):  
Ann Kathleen Burlew

To test whether knowledge about HIV transmission may be one contributing factor to the disproportionately high rates of HIV and AIDS cases among older African Americans, this study examined data from 448 African-American men and women, who completed the AIDS Knowledge and Awareness Scale. Overall the findings supported the hypothesis that older African Americans were not as knowledgeable as their younger counterparts. However, the analyses also indicated older (age 61+) African-American women were significantly less knowledgeable about HIV transmission than the younger women. However, the difference between older and younger men was not significant. One implication is that older African Americans, especially women, should be targets of educational efforts.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S754-S755
Author(s):  
James Muruthi ◽  
J Tina Savla

Abstract Although previous studies have extensively investigated the cross-sectional relationship between social engagement and depressive symptoms in late life, longitudinal studies have produced mixed results. Furthermore, studies on the associations between these two concepts among aging African Americans are few. Using a sample of 1688 older African Americans adults from waves 1 and 7 of the National Health and Aging Trends Study (60% women; Average age = 77 years), the present study investigates the longitudinal associations between social engagement (an index from scores on visiting friends and family, attending religious services, attending religious services, participating in group activities, and going out for enjoyment) and depressive symptoms across seven years. Structural equation modeling was used to test cross-lagged relationships between the variables. Findings suggest that social engagement at baseline significantly predicted subsequent depressive symptoms and social engagement. Depressive symptoms at baseline, however, were not significantly associated with subsequent social engagement. These findings suggest that low social engagement in older African Americans is directly associated with increased depressive symptoms over time, but not vice versa. The implications of these findings are discussed in relation to the barriers of social engagement for older African Americans and its effects on their mental health.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 784-784
Author(s):  
Staja Booker

Abstract African American older adults are living longer with chronic pain, which presents a huge personal and societal burden. A growing group of scholars are now devoted to accurately and precisely characterizing and phenotyping the experience of pain in aging using within-group and advanced methodological designs to elucidate the biopsychosocial-behavioral responses to pain. In this symposium, five dynamic presenters present new evidence on mechanisms of pain in older African-Americans. Dr. Roach’s investigation reveals the effect of genetic alterations of sickle cell disease (SCD) on stress-related pain in younger and older adults; this scientific inquiry is especially important because there is little research on SCD in aging. Next, Dr. Terry, extends these findings by exploring the association between psychosocial factors such as experiences of discrimination, pain catastrophizing, and perceived stress on neural (brain) responses via magnetic resonance imaging. From a clinical perspective, Dr. Booker reports on the first-ever model of intra-racial differences in movement-evoked pain in older African-Americans with knee osteoarthritis and healthy controls. Our final two presenters use a translational approach to identify how older African-Americans cope with chronic pain. Dr. Robinson-Lane’s study highlights the unique experience and predictors of coping, adaptation, and self-management of chronic pain in Black dementia caregivers. Finally, Dr. Cobb’s research from a large cross-sectional study correlates social, behavioral, and health factors with opioid and psychotropic use in economically disadvantaged older African-Americans. This symposium offers novel ways of understanding social determinants of pain and assisting African-Americans and their caregivers to manage complex chronic pain in later life.


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