Browsing by Subject "cancer-related pain"

Now showing 1 - 3 of 3
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    Cancer-Related Pain and Disability: A Longitudinal Study
    (2011-12) Wang, Hsiao-Lan; Kroenke, Kurt; Wu, Jingwei; Tu, Wanzhu; Theobald, Dale; Rawl, Susan M.
    Context Although the cross-sectional association between cancer-related pain and disability is well established, their longitudinal relationship has been less studied. Objectives Data from the Indiana Cancer Pain and Depression (INCPAD) trial were analyzed to determine whether baseline cancer-related pain and changes in pain over time predict disability over 12 months. Methods A total of 274 cancer survivors with cancer-related pain were accrued in the INCPAD trial. Data were collected at baseline, one, three, six, and 12 months by interviewers blinded to treatment arm. Disability outcomes included a continuous measure (Sheehan Disability Scale [SDS] score) and a categorical measure (≥14 days in the past four weeks with a ≥50% reduction in usual activities). Predictor variables, operationalized by the Brief Pain Inventory, included baseline pain severity and changes in pain severity scores between each time point. Multivariable analyses were conducted adjusting for treatment group, baseline disability, and selected covariates including depression. Results Baseline pain severity did not predict disability outcomes at 12 months. However, improvement in pain severity predicted less disability over 12 months both in terms of SDS scores (b = −0.17, t = −5.33, P < 0.001) and ≥14 disability days in the past month (odds ratio = 0.85; 95% confidence interval, 0.79–0.93; P < 0.001). Conclusion Disability over 12 months in patients with cancer-related pain is predicted by changes in pain severity over time. Results suggest that effective pain management may reduce subsequent disability among cancer survivors.
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    Predictors of Cancer-related Pain Improvement Over Time
    (2012-07) Wang, Hsiao-Lan; Kroenke, Kurt; Wu, Jingwei; Tu, Wanzhu; Theobald, Dale; Rawl, Susan M.
    Objective To determine the predictors of pain improvement among patients being treated for cancer-related pain over 12 months. Methods A secondary analysis of the telephone care Indiana Cancer Pain and Depression trial was performed. Patients (n = 274) were interviewed at baseline and after 1, 3, 6, and 12 months. Pain improvement outcomes included both a continuous measure (Brief Pain Inventory score) and a categorical measure (pain improved versus pain not improved). Predictor variables included change in depression, age, sex, race, marital status, socioeconomic disadvantage, medical comorbidity, type of cancer, and phase of cancer. Multivariable repeated measures were conducted, adjusting for intervention group assignment, baseline pain severity, and time in months since baseline assessment. Results Factors significantly predicting both continuous and categorical pain improvement included participating in the intervention group (β = −0.92, p < .001, odds ratio [OR] = 2.53, 95% confidence interval [CI] = 1.65–3.89), greater improvement in depression (β = −0.31, p = .003, OR = 1.84, 95% CI = 1.35–2.51), higher socioeconomic status (Socioeconomic Disadvantage index; β = 0.25, p = .034; OR = 0.73, 95% CI = 0.56–0.94), and fewer comorbid conditions (β = 0.20, p = .002; OR = 0.84, 95% CI = 0.73–0.96). Patients with more severe pain at baseline or with recurrent or progressive cancer were less likely to experience continuous or categorical pain improvement, respectively. Conclusions Effective management of depression and comorbid conditions along with improvement of social services could be critical components of a comprehensive pain management. Patients with more severe pain or with recurrent or progressive cancers may require closer monitoring and adequate treatment of pain.
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    Shoulder Pain, Functional Status, and Health-Related Quality of Life after Head and Neck Cancer Surgery
    (2013-12) Wang, Hsiao-Lan; Keck, Juanita F.; Weaver, Michael T.; Mikesky, Alan; Bunnell, Karen; Buelow, Janice M; Rawl, Susan M.
    Head and neck cancer (HNC) patients experience treatment-related complications that may interfere with health-related quality of life (HRQOL). The purpose of this study was to describe the symptom experience (shoulder pain) and functional status factors that are related to global and domain-specific HRQOL at one month after HNC surgery. In this exploratory study, we examined 29 patients. The outcome variables included global HRQOL as well as physical, functional, emotional, and social well-being. Symptom experience and functional status factors were the independent variables. In the symptom experience variables, shoulder pain distress was negatively associated with physical well-being (R2 = 0.24). Among the functional status variables, eating impairment was negatively related to global HRQOL (R2 = 0.18) and physical well-being (R2 = 0.21). Speaking impairment and impaired body image explained a large amount of the variance in functional well-being (R2 = 0.45). This study provided initial results regarding symptom experience and functional status factors related to poor HRQOL in the early postoperative period for HNC patients.