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Soto SH, Berry DC, Callahan LF. Qualitative Exploration of Dyadic Influence on Physical Activity Between Latina Patients With Osteoarthritis and a Supporter of Their Physical Activity. Arthritis Care Res (Hoboken) 2022; 74:281-290. [PMID: 32976699 PMCID: PMC7990739 DOI: 10.1002/acr.24460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 09/01/2020] [Accepted: 09/15/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Research indicates that social support may promote physical activity; however, most Latina individuals with osteoarthritis (OA) are not sufficiently active. The purpose of this qualitative dyadic study was to explore how Latina patients with OA and a self-selected physical activity "supporter" motivate each other to be more active. Furthermore, perceptions of how OA symptoms impact support and physical activity were examined. METHODS Semistructured dyadic interviews were conducted with Latina patients with OA and a member of their social network age ≥16 years who supports their physical activity (n = 14 dyads). We used framework analysis to reduce qualitative data to themes and subthemes. RESULTS Daughters (n = 5), spouses (n = 4), sons (n = 2), a granddaughter (n = 1), a nephew (n = 1), and a friend (n = 1) provided support for the target behavior. In many cases, members of dyads said the motivation to engage in physical activity was reciprocated rather than focused solely on Latina patients with OA. Support was often reciprocated by engaging in physical activity together, using pressure, talking about being active, modeling physical activity, and helping with household responsibilities. Although participants agreed that physical activity was beneficial and Latina patients desired additional support when experiencing OA symptoms, there was concern about the safety of activity in the presence of symptoms. Several adult daughters indicated that their mothers' OA symptoms motivated their own physical activity. CONCLUSION Dyadic strategies for promoting physical activity among Latina patients with OA and how support may be reciprocated were identified.
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Affiliation(s)
- Sandra H. Soto
- UNC, Chapel Hill, School of Nursing, Carrington Hall, Campus Box 7460, Chapel Hill, NC 27599-7460,Thurston Arthritis Research Center, 3300 Thurston Bldg., Campus Box 7280, Chapel Hill, NC 27599
| | - Diane C. Berry
- UNC, Chapel Hill, School of Nursing, Carrington Hall, Campus Box 7460, Chapel Hill, NC 27599-7460
| | - Leigh F. Callahan
- Thurston Arthritis Research Center, 3300 Thurston Bldg., Campus Box 7280, Chapel Hill, NC 27599,UNC, Division of Rheumatology, Allergy and Immunology, Department of Medicine, 125 MacNider Hall, Campus Box #7005, Chapel Hill, NC 27599-7280
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Vilen L, Cleveland RJ, Callahan LF. Educational Attainment, Health Status, and Program Outcomes in Latino Adults With Arthritis Participating in a Walking Program. Prev Chronic Dis 2018; 15:E128. [PMID: 30339771 PMCID: PMC6198678 DOI: 10.5888/pcd15.180129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction Latinos are disproportionately likely to lack a high school diploma, compared with non-Hispanic whites, a trend associated with worse outcomes in arthritis and indicating a need for health interventions. Camine Con Gusto (CCG) is the Spanish version of the evidence-based Walk With Ease program for arthritis. This study compared baseline health status and examined differences in program efficacy and adherence among Latino adults with and without a high school diploma enrolled in a pre−post evaluation of CCG. Methods CCG participants (n = 233) were classified into 2 groups: high school diploma or more (n = 129) and less than high school diploma (n = 104). We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations of education with measures of baseline health and program adherence. We computed effect sizes for the difference between education groups by using mean change scores for arthritis symptoms, physical function, and psychosocial variables. Results The group without a high school diploma was more likely to report worse general health (OR = 2.40; 95% CI, 1.28–4.53) and lower levels of arthritis self-efficacy (OR = 1.95; 95% CI, 1.05–3.63) than the group with a high school diploma. CCG improved outcomes for both groups, with no significant between-group differences. The group without a high school diploma was less likely to read most of the program workbook (OR = 0.51; 95% CI, 0.27–0.97), but we found no significant differences in the amount of walking between the 2 groups. Conclusion CCG was equally effective among Latinos with and without a high school diploma; however, education did affect participants’ engagement with the program workbook. Adaptation of interventions for Latinos should consider how information can best be conveyed to those with lower levels of formal education.
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Affiliation(s)
- Leigha Vilen
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Thurston Arthritis Research Center, CB 7280, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7305.
| | - Rebecca J Cleveland
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Division of Rheumatology and Immunology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Leigh F Callahan
- Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Division of Rheumatology and Immunology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Departments of Social Medicine and Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Responding to health and social needs of aging Latinos in new-growth communities: a qualitative study. BMC Health Serv Res 2017; 17:601. [PMID: 28841873 PMCID: PMC6389113 DOI: 10.1186/s12913-017-2551-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 08/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The development of new-growth communities of Latino immigrants in southern states has challenged the traditional health and social service infrastructure. An interprofessional team of service providers, Latino leaders, and university faculty partnered to establish linkages with the Latino community and providers serving aging adults and to explore the health and social needs of aging Latinos residing in a rural region. METHODS A qualitative descriptive study was conducted through a community-university partnership, the Aging Latino Research Team (ALRT). Data were generated from nine focus groups and 15 key informant interviews with Latino and non-Latino community members and service providers in rural, eastern North Carolina (ENC). RESULTS Thematic analysis was used to identify common patterns and form recommendations for future research and programs. Themes common to Latino participants were: "We are put off to one side"; "If I can't work, I can't survive"; and "Without documents, you are no one." Themes common to non-Latino participants were: "Older Latinos are not well served"; "Older Latinos are invisible"; "Older Latinos are undocumented and afraid"; and "Older Latinos are wandering the highway". CONCLUSION A major finding of this research was the extent to which discrepancies in perceptions between Latino participants and non-Latino participants exist. These discrepancies revealed ethnic stereotyping and cultural insensitivity as major barriers in access to care.
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Guzman A. Exploring the Chronic Illness Experience of Rural-Dwelling Latinos of Mexican Origin. HISPANIC HEALTH CARE INTERNATIONAL 2016; 14:177-183. [PMID: 27913691 DOI: 10.1177/1540415316677720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Chronic illness is a complex and ever-growing phenomenon that is affecting millions of Americans every day, and it is disproportionately experienced by Latinos of Mexican origin. METHOD In this quantitative study, the specific aims were to evaluate perceptions of chronic illness(es), locus of control (health and God), health status, and cultural orientation of rural-dwelling Latinos of Mexican origin in Colorado who have one or more chronic illnesses and to explore the relationships existing between these concepts. RESULTS A sample of 102 varied from overall national statistics for this population in the United States by gender, mean annual income, and education completed. CONCLUSION As Latinos of Mexican origin move toward becoming the largest minority population in the United States, it is important to improve the body of nursing science that targets this population.
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Hollingshead NA, Ashburn-Nardo L, Stewart JC, Hirsh AT. The Pain Experience of Hispanic Americans: A Critical Literature Review and Conceptual Model. THE JOURNAL OF PAIN 2016; 17:513-28. [PMID: 26831836 PMCID: PMC4851887 DOI: 10.1016/j.jpain.2015.10.022] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 10/21/2015] [Accepted: 10/31/2015] [Indexed: 01/22/2023]
Abstract
UNLABELLED Although the Hispanic population is a burgeoning ethnic group in the United States, little is known about their pain-related experience. To address this gap, we critically reviewed the existing literature on pain experience and management among Hispanic Americans (HAs). We focused our review on the literature on nonmalignant pain, pain behaviors, and pain treatment seeking among HAs. Pain management experiences were examined from HA patients' and health care providers' perspectives. Our literature search included variations of the term "Hispanic" with "AND pain" in PubMed, Embase, Web of Science, ScienceDirect, and PsycINFO databases. A total of 117 studies met our inclusion criteria. We organized the results into a conceptual model with separate categories for biological and/or psychological and sociocultural and/or systems-level influences on HAs' pain experience, response to pain, and seeking and receiving pain care. We also included information on health care providers' experience of treating HA patients with pain. For each category, we identified future areas of research. We conclude with a discussion of limitations and clinical implications. PERSPECTIVE In this critical review of the literature we examined the pain and management experiences of the HA population. We propose a conceptual model, which highlights findings from the existing literature and future areas of research.
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Affiliation(s)
- Nicole A Hollingshead
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
| | - Leslie Ashburn-Nardo
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana.
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Abstract
OBJECTIVE The objective of this study is to examine the strategies used to manage chronic pain from the perspective of the individual in group interviews. METHODS Sixteen low-income overweight Latino adults participated in two group interviews facilitated by a trained moderator who inquired about the type of chronic pain suffered by participants, followed by more specific questions about pain management. Interviews were audio-recorded, transcribed verbatim (Spanish), back-translated into English, and analyzed using thematic analysis. RESULTS Participants' pain varied in type, location, and intensity. Participants discussed pain-related changes in activities and social life, and difficulties with health care providers, and as a result, we discovered five major themes: pain-related life alterations, enduring the pain, trying different strategies, emotional suffering, and encounters with health care system/providers. DISCUSSION Findings indicated that there are opportunities for providers to improve care for low-income overweight Latinos with chronic pain by listening respectfully to how pain alters their daily lives and assisting them in feasible self-management strategies.
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Affiliation(s)
- Dana N Rutledge
- School of Nursing, California State University, Fullerton, CA 92831, USA.
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Gong G, Li J, Li X, Mao J. Pain experiences and self-management strategies among middle-aged and older adults with arthritis. J Clin Nurs 2013; 22:1857-69. [PMID: 23534697 DOI: 10.1111/jocn.12134] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2012] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES The purposes were (1) to explore pain experiences and the use and perceived effectiveness of pain self-management methods among middle-aged and older adults with osteoarthritis or rheumatoid arthritis in mainland China and (2) to compare those with diagnoses of osteoarthritis and rheumatoid arthritis. BACKGROUND Prior research has suggested that pain is a major concern for people with arthritis. However, studies systematically investigating pain experiences and self-management status of arthritis patients are scarce in mainland China. DESIGN Descriptive survey. METHODS Participants (n = 197) aged 45 and over, diagnosed with either osteoarthritis or rheumatoid arthritis, and experiencing persistent pain were administered three self-report questionnaires: the Demographic Data Questionnaire, the Brief Pain Inventory and the Pain Management Inventory. RESULTS The mean of the overall pain intensity was 5.6 (SD = 1.3). The median of number of pain sites was 7.0 (QR = 7.0) and the overall pain interference was 6.0 (QR = 2.6). Most participants experienced moderate to severe pain and interference. The current methods used for managing pain were perceived as only moderately effective. The sample used a median of 4.0 (QR = 3.0) self-management methods. Most often used were prescribed medicine, massage, heat and activity pacing. Methods perceived as most helpful included prescribed medicine, over-the-counter medicine, hot baths and heat. Persons with rheumatoid arthritis had significantly more pain sites, higher pain intensity and greater number of pain management methods used compared to those with osteoarthritis. CONCLUSIONS Pain management is a significant problem in this population. The findings highlight the importance of helping the individual to identify and appropriately use a variety of self-management methods, selecting the appropriate method(s) at any one time. RELEVANCE TO CLINICAL PRACTICE Healthcare providers are urged to develop appropriate interventions on pain management tailored to arthritis patients in mainland China.
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Affiliation(s)
- Guilan Gong
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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McDonald DD, Molloy B. Factors predicting older adults' use of exercise and acetaminophen for osteoarthritis pain. JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS 2012; 24:669-74. [PMID: 23088698 DOI: 10.1111/j.1745-7599.2012.00747.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To identify predictors of older adults' use of exercise and/or acetaminophen, and avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs) to treat their osteoarthritis pain. DATA SOURCES Data were analyzed from 457 adults aged 60 and older with moderate or greater osteoarthritis pain intensity who responded to the Brief Pain Inventory between 2006 and 2007. The following predictors were entered into a logistic regression to predict use of exercise and/or acetaminophen and nonuse of NSAIDs: age, gender, ethnicity, race, education, arthritis treatment by a practitioner, pain treatment by a practitioner, pain intensity, functional interference from the pain, and percent of pain relief from current treatments. CONCLUSIONS A total of 213 (46.6%) reported using exercise and/or acetaminophen and did not report using NSAIDs. Older adults reporting arthritis treatment by a practitioner were 2.2 (confidence interval 1.08-4.59) more likely to use recommended arthritis pain treatment, p < .03. Only 3-4% of the variance for use of recommended pain management treatment was explained by the predictors. IMPLICATIONS FOR PRACTICE Results underscore the importance of guidance by practitioners who are knowledgeable about safe osteoarthritis pain management for older adults.
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