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Factors Affecting Pain Management Self-Advocacy in Women Aged 65 and Older with Breast Cancer

Alsbrook, Karen Elizabeth (2022) Factors Affecting Pain Management Self-Advocacy in Women Aged 65 and Older with Breast Cancer. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Background: Despite advancements in treating cancer and cancer-related pain, patients with breast cancer continue to self-report high percentages of pain. Because women aged 65 and older comprise the highest percentage of breast cancer survivors, much attention is due to this group to determine the extent and the cause of undermanaged pain. Therefore, the purpose of this study was to understand factors that affect pain management and pain self-advocacy experiences of in this group of women treated for breast cancer.
Methods: Females aged 65 and older were recruited from a larger ongoing longitudinal study. For the first aim, we employed qualitative descriptive methodology to interviews with 21 study participants, aged 65 or older, who endorsed pain scores of 4/10 or higher at least once during parent study participation. Questions focused on interactions with the cancer care team, experiences and practices of reporting and treating their pain, and opinions regarding pain
management with opioid analgesia. For Aim 2, 73 parent study participants aged 65 or older were recruited to participate in a single questionnaire comprised of items from four instruments: the Female Self-Advocacy in Cancer Survivorship scale; the Patient-Centered Communication in Cancer Care (short-form) instrument; the Brief Opioid Stigma Scale; and the Patient-Reported Outcomes Measurement Information System (PROMIS®) Scale v2.0 - Pain Intensity 3a.
Results: The findings from Aim 1 revealed three overarching categories: facilitators of optimal pain management, challenges to optimal pain management, and other factors affecting optimal pain management. The results of Aim 2 revealed negative correlations between scores of pain intensity and perception of patient-centered communication and with opioid stigma agreement. Positive correlations were found between scores for perception of patient-centered
communication and overall self-advocacy, particularly with the informed decision-making, effective communication, and connected strength subscales.
Conclusions: Strategies that employ facilitators of optimal pain management can mitigate barriers that may affect how pain is managed in women aged 65 and older who are breast cancer survivors. Future research should focus on improving patient-centered clinical relationships and increasing self-advocacy skills to promote optimal pain management in this population.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Alsbrook, Karen Elizabethkea64@pitt.edu0000-0002-7610-8558
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairWesmiller, Susan W.swe100@pitt.edu0000-0002-1306-894X
Committee CoChairHagan Thomas, Teresat.thomas@pitt.edu0000-0001-7403-7314
Committee MemberDeVito Dabbs, Annetteajdst42@pitt.edu0000-0003-3325-435X
Committee MemberDiego, Emilia J.diegoe@upmc.edu0000-0003-2155-817X
Committee MemberScott, Paul W.pws5@pitt.edu0000-0001-9896-3179
Date: 15 December 2022
Date Type: Publication
Defense Date: 30 September 2022
Approval Date: 15 December 2022
Submission Date: 3 November 2022
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 197
Institution: University of Pittsburgh
Schools and Programs: School of Nursing > Nursing
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: aged; cancer survivors; communication; pain management; women; analgesics, opioid; cancer pain; patient-centered care
Date Deposited: 15 Dec 2022 16:42
Last Modified: 15 Dec 2022 16:42


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