Factor structure of the Arthritis-Related Health Belief instrument in ethnically diverse community-dwelling older adults with chronic pain

A utilização da acupuntura no controlo da dor crónica em usuários com síndrome vertebral com irradiação

Objetivos: a acupuntura é, cada vez mais, uma técnica utilizada, em usuários portadores de várias patologias, e, em especial, aquelas que são acompanhadas de dor crónica. Esta pesquisa teve como objetivo geral analisar o efeito da terapêutica não farmacológica de acupuntura e eletroacupuntura para o controle da dor crónica, em usuários com diagnóstico médico de síndrome vertebral com irradiação.Métodos: foi realizada uma pesquisa com dois momentos de avaliação – antes e após sessões de terapêutica não farmacológica de acupuntura e eletroacupuntura. Utilizou-se um questionário com variáveis de caracterização sociodemográfica e clínica, o Brief Pain Inventory (BPI) e Short Form 6 Dimensions (SF-6D).Resultados: participaram no estudo 43 usuários, tendo sido encontradas diferenças estaticamente significativas, do momento 1 para o momento 2 de avaliação, quer no domínio da severidade da dor (p<0,01), quer no domínio interferência da dor no funcionamento diário (p<0,01), assim como nas diferentes dimensões do SF-6D foram encontradas diferenças estatisticamente significativas.Conclusões: salienta-se que a terapêutica não farmacológica de acupuntura e eletroacupuntura em usuários com diagnóstico de síndrome vertebral com irradiação e dor crónica contribuiu para a diminuição da severidade da dor, da interferência da dor no funcionamento diário e melhoria da qualidade de vida relacionada com a saúde.

Historical Theoretical Perspectives to Consider in the Application of Community-Based Interventions for African Americans and Communities of Color

Using theory as a framework for community-based interventions in African American members provides the principles and guidance needed to generate nursing knowledge. However, choosing an appropriate theoretical framework to guide community-based interventions can be challenging. The aim of this manuscript is to examine the use of three historical models or theories (the Health Belief Model, the Theory of Planned Behavior, and Bandura's Self-Efficacy Theory), which are still being used today, to better understand their applications in community-based interventions.

A Cross-Sectional Survey of Risky Travel and Leisure Behaviors During the COVID-19 Pandemic

PURPOSE

COVID-19 is largely spread through close contact with infected people in indoor spaces. Avoiding these spaces is one of the most effective ways to slow the spread. This study assessed who had engaged in risky travel and leisure behaviors before the availability of vaccines.

DESIGN

National cross-sectional on-line survey collected in November and December 2020. Setting: United States; Participants: 2589 adults representative by gender and race/ethnicity to the US population; Measures: The survey assessed if people had resumed 11 risky behaviors during the pandemic, prior to vaccines. Independent variables included age, race/ethnicity, region of the country, education, income, preexisting conditions, perceived severity and susceptibility, positive COVID diagnosis, and political ideology.

ANALYSIS

Univariate analysis and logistic regressions were used to assess demographic and psychological factors of those resuming these behaviors. Results: Most (60.3%) of people had resumed at least 1 behavior with eating inside of restaurants (33.2%) and visiting family and friends (37.5%) being the most prevalent. In the multivariate analyses, perceived susceptibility was significant across all behaviors. Young people, fiscal conservatives, and people with higher perceived severity were more likely to perform several of the behaviors. Preexisting conditions did not predict any of the behaviors.

CONCLUSIONS

Travel and leisure behaviors vary by type of risk and may need specific tailored, prevention messages to promote risk reduction during future pandemics.

Factors Associated With Physical Performance Measures in a Multiethnic Cohort of Older Adults

Objective: To explore the association between ethnicity, sociodemographic, health, and lifestyle factors, and physical performance (PP) in ethnically diverse community-dwelling older adults from one geographic area. Method: We used multivariable linear regression to identify factors associated with upper (grip strength [GS], arm curls [AC]) and lower (chair stands [CS]) body strength and mobility (gait speed [GSp]) in 577 older adults (mean age 74 ± 8; 104 African American, 142 Afro-Caribbean, 123 Hispanic, and 208 European American) from South Florida. Results: Worse mental health was negatively associated with CS in African Americans and AC in Hispanics. Older age and higher body mass index (BMI) was associated with slower GSp in all except in Hispanics. Higher physical activity was associated with higher upper body strength in Hispanics and better mobility in African Americans and Afro-Caribbeans, but not in European Americans. Conclusion: Studies with large multiethnic cohorts are needed to further our understanding of ethnic differences in PP, which will help in tailoring interventions and recognizing unmet needs for health and social services.

Self-report pain assessment tools for cognitively intact older adults: Integrative review

BACKGROUND

Pain is common in older adults, but it is often underreported or undertreated partly because many consider pain to be a normal consequence of ageing. Among the plethora of available self-report pain assessment tools, there is no synthetised evidence which tools are indicated for use among cognitively intact older adults.

PURPOSE OF THE STUDY

To understand documented self-report pain assessment tools that have been used among cognitively intact older adults, and to describe their characteristics including overall performance as well as studies demonstrating their use.

METHODS

A systematic search of the indexed databases PubMed, PsycINFO and Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus) was conducted to identify documented self-report pain assessment tools through peer-reviewed papers, including citations from January 1990 to December 2015. Thirty-five percentage of abstracts were independently evaluated by two raters according to specific criteria.

RESULTS

Among identified tools, the Iowa Pain Thermometer, the 6-point Verbal Descriptor Scale, the Numeric Rating Scale, the short form Brief Pain Inventory (BPI) and the Geriatric Pain Measure (GPM) may be suitable tools for self-reported pain by cognitively intact older adults based on the statement of the literature. Only two self-report tools (the GPM and the Geriatric Painful Events Inventory) were designed specifically for older adults.

CONCLUSIONS

More studies are needed to evaluate pain measures' psychometric performance across different settings, racial/ethnic groups and disease categories. Since 80% of older adults have at least one chronic disease, multidimensional tools such as the GPM may need to be used more often for accurate self-report of pain.

IMPLICATIONS FOR PRACTICE

Examining the psychometric properties of comprehensive self-report pain assessment tools informs recommendations for the selection of tools to be used in clinical practice.

The Characteristics of Pain in Patients Diagnosed with Depression and Heart Failure

Heart failure (HF) is a costly and growing health problem that is routinely complicated by chronic pain and depression. The purpose of this paper is to describe the characteristics of pain and pain management in depressed HF patients. In this descriptive cross-sectional study, we analyzed data from 62 participants with depression and class II-IV HF. Study variables of interest were collected from the Brief Pain Inventory, Beck Depression Inventory, and Rand-36. Almost all participants (98%) had some pain in the past month and most had pain in the last 24 hours (66%). The median pain score was 4 (0-10 scale) with the majority reporting moderate to severe pain. The median pain interference score was 4.42 (0-10 scale) with the majority reporting moderate to extreme interference. Medication to treat pain was used by all participants who reported pain, with only 5% also using nonpharmacologic treatment. The majority of participants reported moderate or severe pain while also having moderate to extreme pain interference. Nonpharmacologic pain treatments were severely underused. Women were more likely to have higher levels of pain intensity and more pain interference than men, suggesting that additional screening for the impact of pain is especially important in women. The wide variety of body areas affected, along with moderate to high intensity pain and considerable interference scores reported, indicate that pain was ineffectively treated. Nonpharmacologic treatments should be considered to decrease the impact of pain.