Browsing by Author "Ward, Sandra E."

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    Beliefs About Dysmenorrhea and Their Relationship to Self-Management
    (Wiley, 2016-05-13) Chen, Chen X.; Kwekkeboom, Kristine L.; Ward, Sandra E.; School of Nursing
    Dysmenorrhea 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.
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    Beliefs About Dysmenorrhea and Their Relationship to Self‐Management
    (Wiley, 2016-08) Chen, Chen X.; Kwekkeboom, Kristine L.; Ward, Sandra E.; School of Nursing
    Dysmenorrhea 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.
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    Effects of the WRITE Symptoms Interventions on Symptoms and Quality of Life Among Patients With Recurrent Ovarian Cancers: An NRG Oncology/GOG Study (GOG-0259)
    (American Society of Clinical Oncology, 2022) Donovan, Heidi S.; Sereika, Susan M.; Wenzel, Lari B.; Edwards, Robert P.; Knapp, Judith E.; Hughes, Susan H.; Roberge, Mary C.; Thomas, Teresa H.; Klein, Sara Jo; Spring, Michael B.; Nolte, Susan; Landrum, Lisa M.; Casey, A. Catherine; Mutch, David G.; DeBernardo, Robert L.; Muller, Carolyn Y.; Sullivan, Stephanie A.; Ward, Sandra E.; Obstetrics and Gynecology, School of Medicine
    Purpose: GOG-259 was a 3-arm randomized controlled trial of two web-based symptom management interventions for patients with recurrent ovarian cancer. Primary aims were to compare the efficacy of the nurse-guided (Nurse-WRITE) and self-directed (SD-WRITE) interventions to Enhanced Usual Care (EUC) in improving symptoms (burden and controllability) and quality of life (QOL). Methods: Patients with recurrent or persistent ovarian, fallopian, or primary peritoneal cancer with 3+ symptoms were eligible for the study. Participants completed baseline (BL) surveys (symptom burden and controllability and QOL) before random assignment. WRITE interventions lasted 8 weeks to develop symptom management plans for three target symptoms. All women received EUC: monthly online symptom assessment with provider reports; online resources; and every 2-week e-mails. Outcomes were evaluated at 8 and 12 weeks after BL. Repeated-measures modeling with linear contrasts evaluated group by time effects on symptom burden, controllability, and QOL, controlling for key covariates. Results: Participants (N = 497) reported mean age of 59.3 ± 9.2 years. At BL, 84% were receiving chemotherapy and reported a mean of 14.2 ± 4.9 concurrent symptoms, most commonly fatigue, constipation, and peripheral neuropathy. Symptom burden and QOL improved significantly over time (P < .001) for all three groups. A group by time interaction (P < .001) for symptom controllability was noted whereby both WRITE intervention groups had similar improvements from BL to 8 and 12 weeks, whereas EUC did not improve over time. Conclusion: Both WRITE Intervention groups showed significantly greater improvements in symptom controllability from BL to 8 and BL to 12 weeks compared with EUC. There were no significant differences between Nurse-WRITE and SD-WRITE. SD-WRITE has potential as a scalable intervention for a future implementation study.
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    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 Medicine
    Patient 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.