1
|
Carter B, Jordan A, Forgeron P, Qualter P, Saron H. A shared love: reciprocity and hopefulness in romantic relationships of young adults with chronic pain. FRONTIERS IN PAIN RESEARCH 2023; 4:1179516. [PMID: 37389227 PMCID: PMC10303136 DOI: 10.3389/fpain.2023.1179516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/02/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction Chronic pain (≥3 months) creates pain-related challenges that may negatively affect how young adults perceive themselves, and, indeed, they often report feeling different compared to peers and prospective romantic partners. Most studies of romantic relationships in young adults living with a long-term condition (including pain), do not consider the perspective of their partner. We present the findings of a qualitative, exploratory interview study (Phase 2 of a mixed methods study). This qualitative phase aimed to explore how young adults with chronic pain and their partners navigate romantic relationships. We focused on how young adults perceive and experience their romantic relationships and the impact, challenges, and benefits associated with living with chronic pain. Methods This study used remote (videoconferencing) photo-elicitation interviews with a convenience sample of young adults with chronic pain (aged 18-25 years, UK and Canada) and their partners. Recruitment occurred via social media, pain-related websites and organizations, and professional networks. Five young adults with chronic pain from the UK and Canada formed the e-Advisory Group and provided detailed advice throughout the study. Data analysis used the principles of inductive reflexive thematic analysis to explore the dimensions and meaning of romantic relationships from the views of young adults with chronic pain and their romantic partners. Findings Sixteen young adults participated (seven couples plus two young adults with pain who were interviewed without their partner). The young adults with chronic pain were ages 18-24 years (mean 21.88 years, SD 2.23). Four major interpretive themes were generated: Kindred spirits-we just sort of work; Loving in everyday acts-it's not above and beyond, it's concerned supportiveness; It's OK to be vulnerable with each other-we can talk it through; and You can't see over the horizon-hopes and fears for the future. Discussion Hopefulness and reciprocity were key to the stories shared by the young adults in the current study. Despite the challenges and limitations imposed by chronic pain, their relationships were characterized by partnership and reciprocity, and they were able to be vulnerable with each other and offer each other support.
Collapse
Affiliation(s)
- Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Abbie Jordan
- Centre for Pain Research and Department of Psychology, University of Bath, Bath, United Kingdom
| | - Paula Forgeron
- School of Nursing, University of Ottawa, Ottawa, ON, Canada
| | - Pamela Qualter
- Manchester Institute of Education, University of Manchester, Manchester, United Kingdom
| | - Holly Saron
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| |
Collapse
|
2
|
Mitchell M, Hansen E, Tseng TY, Shen M, Catanzarite Z, Cruz-Oliver D, Parker L, Knowlton A. Caregiver role strain in caring for vulnerable persons living with HIV: correlates of caregiver and care recipient reports. AIDS Care 2022; 34:1314-1320. [PMID: 34445898 PMCID: PMC8881545 DOI: 10.1080/09540121.2021.1968997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 08/09/2021] [Indexed: 01/26/2023]
Abstract
Informal care of family and friends is important for the health and well-being of disadvantaged persons living with HIV (PLWH). Caregiver role strain may threaten the function and continuity of their main relationships and their health impacts. Data were from a disadvantaged, primarily African American, sample of PLWH care recipients. Caregiver role strain was operationalized as a latent factor measured by variables including PLWH's perceptions of their caregiver not wanting or complaining about helping them or wanting a break. We found that greater caregiver role strain was associated with higher levels of HIV-related stigma and depressive symptoms. Lower role strain was associated with more collaborative problem solving and shared medical treatment decision-making. Caregiver role strain was linked to disadvantaged PLWHs' worse stigma and mental health; collaborative engagement in care and coping assistance were protective of role strain. Caregiving relationship-focused research and interventions are needed for resourcing and sustaining disadvantaged African American communities' caregiving and health.
Collapse
Affiliation(s)
| | - Eric Hansen
- Department of Supportive Care, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Tuo-Yen Tseng
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
| | - Mary Shen
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
| | - Zachary Catanzarite
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
| | | | - Lauren Parker
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
| | - Amy Knowlton
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
| |
Collapse
|
3
|
Maragh-Bass AC, Hendricks Sloan D, Aimone EV, Knowlton AR. 'The Woman Gives': Exploring gender and relationship factors in HIV advance care planning among African American caregivers. J Clin Nurs 2021; 30:2331-2347. [PMID: 33829592 DOI: 10.1111/jocn.15772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/24/2021] [Accepted: 03/17/2021] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVE Advance care planning (ACP) is the communication process of documenting future healthcare preferences in case patients are unable to make healthcare decisions for themselves. Research suggests ACP discussions among persons living with HIV (PLHIV) are infrequent overall and may differ by gender and/or race. BACKGROUND Previous literature has displayed that African Americans are less likely than other racial groups to use advanced care planning, palliative care or hospice, but does not conclusively account for ACP among PLHIV. African American PLHIV rely on informal care that may be differ by gender and represents an important pathway to increase ACP. DESIGN The study was mixed methods and observational. METHODS Participants completed self-report surveys (N = 311) and were interviewed (n = 11). Poisson regression (quantitative) and grounded theory analyses (qualitative) were implemented, using COREQ checklist principles to ensure study rigor. RESULTS Less than half had discussed ACP (41.2%; N = 267). More ACP knowledge predicted 76% lower likelihood of ACP discussions among women. Men who spent more time caregiving in a given week were nearly 3 times more likely to discuss ACP than men who spent less time caregiving. Women were more likely than men to be caregivers and were also expected to serve in that role more than men, which was qualitatively described as 'being a woman'. CONCLUSIONS The present study is one of few studies exploring ACP among caregivers in African American populations hardest hit by HIV. Results suggest that ACP skill building and education are critical for African Americans living with HIV to promote ACP discussions with their caregivers. Knowledge about ACP topics was low overall even when healthcare had recently been accessed. Support reciprocity and gender-specific communication skill building may facilitate ACP in African American HIV informal caregiving relationships. RELEVANCE TO CLINICAL PRACTICE Results underscore the need for ACP education which includes healthcare providers and caregivers, given African Americans' preference for life-sustaining treatments at end-of-life. ACP is crucial now more than ever, as COVID-19 complicates care for older adults with HIV at high risk of complications.
Collapse
Affiliation(s)
- Allysha C Maragh-Bass
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Duke Global Health Institute, Durham, North Carolina, USA
| | - Danetta Hendricks Sloan
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Elizabeth V Aimone
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Duke Global Health Institute, Durham, North Carolina, USA
| | - Amy R Knowlton
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
4
|
Joseph V, Jones A, Canidate S, Mannes Z, Lu H, Ennis N, Ibanez G, Somboonwit C, Cook R. Factors associated with current and severe pain among people living with HIV: results from a statewide sample. BMC Public Health 2020; 20:1424. [PMID: 32948167 PMCID: PMC7501653 DOI: 10.1186/s12889-020-09474-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 08/30/2020] [Indexed: 11/17/2022] Open
Abstract
Background People living with HIV (PLHIV) are more likely to suffer from pain compared to the general public. Pain often clusters with mental health symptoms and substance use. This study sought to evaluate mental health and substance use factors associated with any pain and severe pain intensities among PLHIV. Methods Data were derived from HIV+ adults (N = 733) recruited from community health centers across Florida who completed questionnaires regarding demographics, chronic pain, HIV clinical outcomes, mental health symptoms, and substance use information. Pain was assessed using the Brief Pain Inventory (BPI) short form. Multivariate logistic regression analysis was utilized to assess the relationship between selected covariates and pain. Results Approximately half (45.0%) of participants reported having any current pain while 16.1% reported severe pain. The odds of having any current pain were 2.49 (CI 95% 1.48, 4.18, p < 0.01) times greater among PLHIV reporting anxiety and 1.69 (CI 95% 1.11, 2.57, p = 0.01) times greater among PLHIV reporting PTSD compared to those without those factors. The odds of having severe pain were 2.03 (CI 95% 1.03, 4.01, p = 0.04) times greater among PLHIV reporting anxiety and 2.02 (CI 95% 1.26, 3.24, p < 0.01) times greater among female participants compared to PLHIV without those factors respectively. Factors including depression, alcohol consumption, and marijuana use were not statistically associated with any current pain nor with severe pain. Conclusion The relationship between pain and mental health is complex. Thus, future research is needed to determine if pain treatments may reduce mental health symptoms or if treatments can be targeted to address both issues simultaneously.
Collapse
Affiliation(s)
- Verlin Joseph
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, P.O. Box 100231, 2004 Mowry Road, Gainesville, FL, 32610, USA.
| | - Abenaa Jones
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Shantrel Canidate
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, P.O. Box 100231, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Zachary Mannes
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, P.O. Box 100231, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Huiyin Lu
- Fred Hutchinson Cancer Research Center, University of Washington, 1100 Fairview Ave N, Seattle, WA, 98109, USA
| | - Nichole Ennis
- Department of Behavioral Sciences and Social Medicine, Center for Translational Behavioral Sciences, College of Medicine, Florida State University, 2010 Levy Ave, Bldg. B, suite 266, Tallahassee, FL, 32310, USA
| | - Gladys Ibanez
- Department of Epidemiology, Florida International University, 11200 S.W. 8th Street, Building AHC-5, Room 478, Miami, Florida, 33199, USA
| | - Charurut Somboonwit
- Division of Infectious Disease and International Medicine, Morsani College of Medicine, University of South Florida, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Robert Cook
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, P.O. Box 100231, 2004 Mowry Road, Gainesville, FL, 32610, USA
| |
Collapse
|
5
|
Nabunya P, Padgett D, Ssewamala FM, Courtney ME, Neilands T. Examining the nonkin support networks of orphaned adolescents participating in a family-based economic-strengthening intervention in Uganda. JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 47:579-593. [PMID: 30394541 PMCID: PMC6397685 DOI: 10.1002/jcop.22139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 06/08/2023]
Abstract
In this study, we examined the nonkin support networks of orphaned adolescents participating in a family-based economic-strengthening intervention in HIV-impacted communities in Uganda. We analyzed data from a cluster randomized experimental study for orphaned adolescents aged 11-17 years. Participants were randomly assigned to either the control condition, which received bolstered standard of care (BSOC) services, or the treatment condition, which received BSOC services plus an economic-strengthening intervention. We conducted binary logistic regression analyses to examine the effect of the intervention on participants' nonkin support networks. Results indicated that the existing social support networks for orphaned adolescents are small, limited, and usually comprised individuals with similar socioeconomic situations and challenges. Because orphaned adolescents are socially isolated and the threshold for nonkin supportive services is very low, the BSOC services provided to the control condition appeared to be instrumental in their survival and well-being. Availability of personal savings was associated with higher odds of identifying at least one supportive nonkin tie. The extended family system is still the primary and major source of social support to orphaned children in HIV-affected communities. In the absence of public safety nets, building social assets, over and above offering economic opportunities to extended families supporting orphaned children, is critical.
Collapse
Affiliation(s)
- Proscovia Nabunya
- Brown School of Social Work, Washington University in St. Louis, Campus Box, 1196, One Brookings Drive, St. Louis, MO, 63130,
| | - Deborah Padgett
- New York University Silver School of Social Work, 1 Washington Square North, New York, NY 10003,
| | - Fred M. Ssewamala
- International Center for Child Health and Development, Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130,
| | - Mark E. Courtney
- The University of Chicago School of Social Service Administration, 969 E. 60th Street, Chicago, IL 60637,
| | - Torsten Neilands
- University of California San Francisco School of Medicine, 550 16th Street, San Francisco, CA 94158,
| |
Collapse
|
6
|
Scott W, Arkuter C, Kioskli K, Kemp H, McCracken LM, Rice AS, de C. Williams AC. Psychosocial factors associated with persistent pain in people with HIV: a systematic review with meta-analysis. Pain 2018; 159:2461-2476. [PMID: 30130299 PMCID: PMC6250281 DOI: 10.1097/j.pain.0000000000001369] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/26/2018] [Indexed: 01/11/2023]
Abstract
Chronic pain remains a prevalent and disabling problem for people living with HIV in the current antiretroviral treatment era. Psychosocial treatments may have promise for managing the impact of this pain. However, research is needed to identify psychosocial processes to target through such treatments. The current systematic review and meta-analysis examined the evidence for psychosocial factors associated with pain, disability, and quality of life in people living with HIV and persistent pain. Observational and experimental studies reporting on the association between one or more psychosocial factors and one or more pain-related variables in an adult sample of people living with HIV and pain were eligible. Two reviewers independently conducted eligibility screening, data extraction, and quality assessment. Forty-six studies were included in the review and 37 of these provided data for meta-analyses (12,493 participants). "Some" or "moderate" evidence supported an association between pain outcomes in people with HIV and the following psychosocial factors: depression, psychological distress, posttraumatic stress, drug abuse, sleep disturbance, reduced antiretroviral adherence, health care use, missed HIV clinic visits, unemployment, and protective psychological factors. Surprisingly, few studies examined protective psychological factors or social processes, such as stigma. There were few high-quality studies. These findings can inform future research and psychosocial treatment development in this area. Greater theoretical and empirical focus is needed to examine the role of protective factors and social processes on pain outcomes in this context. The review protocol was registered with PROSPERO (CRD42016036329).
Collapse
Affiliation(s)
- Whitney Scott
- Health Psychology Section, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Chinar Arkuter
- Health Psychology Section, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Kitty Kioskli
- Health Psychology Section, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Harriet Kemp
- Pain Research Group, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Lance M. McCracken
- Health Psychology Section, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
- INPUT Pain Management Unit, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Andrew S.C. Rice
- Pain Research Group, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Amanda C. de C. Williams
- Research Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
| |
Collapse
|