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Browsing by Author "Ward, Sandra E."
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Item Beliefs About Dysmenorrhea and Their Relationship to Self-Management(Wiley, 2016-05-13) Chen, Chen X.; Kwekkeboom, Kristine L.; Ward, Sandra E.; School of NursingDysmenorrhea is highly prevalent and is the leading cause of work and school absences among women of reproductive age. However, self-management of dysmenorrhea is not well understood in the US, and little research has explored factors that influence dysmenorrhea self-management. Guided by the Common Sense Model, we examined women’s representations of dysmenorrhea (beliefs about causes, symptoms, consequences, timeline, controllability, coherence, and emotional responses), described their dysmenorrhea self-management behaviors, and investigated the relationship between representations and self-management behaviors. We conducted a cross-sectional, web-based survey of 762 adult women who had dysmenorrhea symptoms in the last six months. Participants described various causes of their dysmenorrhea symptoms which were perceived as a normal part of life. Dysmenorrhea symptoms were reported as moderately severe, with consequences that moderately affected daily life. Women believed they understood their symptoms moderately well, and perceived them as moderately controllable, but expected their timeline to continue through menopause. Most women did not seek professional care but rather used a variety of pharmacologic and complementary health approaches. Care seeking and use of self-management strategies were associated with common sense beliefs about dysmenorrhea cause, consequences, timeline, and controllability. The findings may inform development and testing of self-management interventions that address dysmenorrhea representations and facilitate evidence-based management.Item Beliefs About Dysmenorrhea and Their Relationship to Self‐Management(Wiley, 2016-08) Chen, Chen X.; Kwekkeboom, Kristine L.; Ward, Sandra E.; School of NursingDysmenorrhea is highly prevalent and is the leading cause of work and school absences among women of reproductive age. However, self‐management of dysmenorrhea is not well understood in the US, and little evidence is available on factors that influence dysmenorrhea self‐management. Guided by the Common Sense Model, we examined women's representations of dysmenorrhea (beliefs about causes, symptoms, consequences, timeline, controllability, coherence, and emotional responses), described their dysmenorrhea self‐management behaviors, and investigated the relationship between representations and self‐management behaviors. We conducted a cross‐sectional, web‐based survey of 762 adult women who had dysmenorrhea symptoms in the last six months. Participants had varied beliefs about the causes of their dysmenorrhea symptoms, which were perceived as a normal part of life. Dysmenorrhea symptoms were reported as moderately severe, with consequences that moderately affected daily life. Women believed they understood their symptoms moderately well and perceived them as moderately controllable but them to continue through menopause. Most women did not seek professional care but rather used a variety of pharmacologic and complementary health approaches. Care‐seeking and use of self‐management strategies were associated with common sense beliefs about dysmenorrhea cause, consequences, timeline, and controllability. The findings may inform development and testing of self‐management interventions that address dysmenorrhea representations and facilitate evidence‐based management.Item Revisiting patient-related barriers to cancer pain management in the context of the US opioid crisis(Wolters Kluwer, 2021) Kwekkeboom, Kristine; Serlin, Ronald C.; Ward, Sandra E.; LeBlanc, Thomas W.; Ogunseitan, Adeboye; Cleary, James; Medicine, School of MedicinePatient fear of addiction is a well-documented barrier to the use of analgesic medications for cancer pain control. Over the past 2 decades in the United States, an "opioid crisis" has arisen, accompanied by risk messages delivered through news outlets, public health education, and patient-provider communication. The purpose of this study was to determine if patient-related barriers to cancer pain management-specifically, fears of addiction-and related pain outcomes (pain severity, pain interference with daily life, and adequacy of pain management) have worsened over the last 20 years. A sample of 157 outpatients with active recurrent or active metastatic cancer completed the Barriers Questionnaire-II (BQ-II) and measures of pain and analgesic use. We identified 7 comparison studies published between 2002 and 2020 that reported patient-related barriers using the BQ-II. Significant linear relationships were found between later year of publication and greater fear of addiction (harmful effect subscale score, B = 0.0350, R2 = 0.0347, F1,637 = 23.19, P < 0.0001) and between year of publication and more pain management barriers overall (total BQ-II score, B = 0.039, R2 = 0.065, F1,923 = 73.79, P < 0.0001). Relationships between BQ-II scores (harmful effect and total) and pain outcomes did not change over time. Despite worsening in patient-related barriers, the proportion of patients with adequate vs inadequate analgesic use did not differ over time. Notably, 40% of participants reported inadequate analgesic use, a statistic that has not improved in 20 years. Additional research is necessary to clarify factors contributing to changing beliefs. Findings indicate a continuing need for clinical and possibly system/policy-level interventions to support adequate cancer pain management.