Help for osteoarthritis pain in African American elders (HOPE): Patterns, predictors, and preferences of osteoarthritis and chronic joint pain self-management
View File(s)
Visitor Statistics
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Country | Visits |
---|
Top Visiting Cities
City | Visits |
---|
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Booker, Staja Quinae by View
Title | Page Views |
---|
Popular Works for Booker, Staja Quinae by Download
Title | Downloads |
---|
View Citations
Citations
Introduction: Chronic joint (CJ) pain is the foremost osteoarthritis (OA) symptom that affects older African Americans' (AAs) functional ability. Every effort should be made to reduce the development of high-impact chronic pain. One way to effectively do this is for older AAs to consistently engage in self-management utilizing the recommended OA treatments. Recommended behaviors include land-based exercise, water-based exercise, strength (muscle and endurance) training and stretching, self-management education, analgesic medications, thermal (warm/cool) modalities, and use of assistive and/or orthotic devices. However, evidence suggests these core behaviors of chronic pain self-management are not optimally utilized in older AAs.
Methods: A convergent, parallel mixed-methods study explored patterns, preferences, and predictors of stage of engagement (pre-contemplation, preparation, or action) in recommended OA and CJ self-management behaviors. One hundred ten AAs aged 50 and older from communities in north Louisiana completed quantitative surveys, and a subset of 18 participated in audio-recorded qualitative interviews. Using SPSS, multinomial and binomial regression were used to build predictive models to determine which contextual and cognitive factors predict stage of engagement in each recommended and complementary OA self-management behaviors. A qualitative descriptive approach underscored a conventional content analysis of qualitative data.
Results: Older AAs were “dealin’ with it [pain]” in a variety of ways, and their experience of having OA and CJ pain was based on their ability and willingness to bear the pain, understand the nature of OA pain, and experience life with daily pain. These dimensions of dealin’ with pain acted as a catalyst for engagement in complementary and recommended behaviors. In addition, participants’ and providers’ cultural receptivity may limit or enable engagement in certain recommended evidence-based OA behaviors. Specifically, each recommended OA self-management behavior was associated with different predictors of engagement. Confidence to manage pain was a predictor for land-based exercise, while there were no factors associated with water-based exercise. The most reasonable explanation for this finding of lack of participation in water-based exercise is likely due to inability to swim and lack of access to a personal or community pool. Engagement in strength training was significantly associated with confidence, knowledge of strength training recommendation, motivation, pain interference, and spirituality. For self-management education, only knowledge of self-management education recommendation was a predictor. Most AA older adults were unaware that this was recommended or didn’t have access to a self-management program; subsequently the majority had never participated in such but were in the preparation stage. Predictors for medication use included confidence, knowledge, and pain interference. Almost all AAs were using either over-the-counter or prescribed medications. Use of thermal modalities was predicted by pain interference. Lastly, using assistive and/or orthotic devices was significantly associated with employment status, OA pain severity, pain interference, and perceived social support. Assistive and/or orthotic device use was evenly split between users and non-users. Pain interference emerged as the most salient factor predicting stage of engagement in any of the recommended behaviors. Depending on the specific behaviors, pain interference prevented or motivated engagement.
Conclusion: OA and CJ pain is a significant symptom in older AAs. This study’s mixed method approach uncovered what older AAs do to manage pain. More specifically, these results illuminate the daily patterns and preferences for self-management. We identified specific barriers and motivators that influence engagement in OA self-management behaviors, and determined the most relevant predictors for each stage of engagement. In addition, we were able to develop a model of OA and CJ pain self-management based on the predictors.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 10263045; ProQuest document ID: 1935982305. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | N/A |
Research Approach | Mixed/Multi Method Research |
Keywords | Older Adults; African Americans; Osteoarthritis; Chronic Pain; Patient Self-Management; Joint Pain |
Grantor | The University of Iowa |
Advisor | Herr, Keela A.; Tripp-Reimer, Toni |
Level | PhD |
Year | 2017 |
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Related items
Showing items related by title, author, creator and subjects.
-
Cancer pain treatment differences in a matched sample of older African-American and European-American hospice patients at the end-of-life
Booker, Staja Q.; Herr, Keela; McCarthy, Ann Marie (2016-03-17)Session presented on Sunday, July 26, 2015: Differences in the experience and treatment of cancer pain between African American and European American adults in community settings are noted in the literature. However, ... -
Predictors of self-management for chronic low back pain
Kawi, Jennifer (2014-11-17)Session presented on Sunday, July 27, 2014: Purpose: This research study aimed to: (a) identify variables that best predict self-management (SM) of chronic low back pain (CLBP), and (b) evaluate differences in these ... -
The experiences of Black American older adults managing pain: A nursing ethnography
Robinson-Lane, Sheria G.Introduction: Pain can negatively affect quality of life for Black elders. They are less likely to report pain concerns and have voiced pain needs adequately met. To better understand the pain management experiences and ... -
The impact of various influences on self-management of adult African-Americans with asthma
Holland, James Daniel (2016-03-21)Session presented on Tuesday, November 10, 2015: There are approximately 22.2 million Americans who are living with asthma and of those 18.4 millon are adults. African Americans are more likely to be diagnosed with asthma ... -
The relationship between self-efficacy beliefs toward self-management of asthma and asthma self-management behaviors in urban African American children
Kaul, Teresa LouiseAfrican American children in the United States are disproportionately affected by childhood asthma. Despite the enormous effort that has gone into developing educational interventions to teach patients and families ...