Skip to main content

Advertisement

SpringerLink
Log in

Pain, depressive symptoms, and self-efficacy for pain management: examination in African-American women with breast cancer

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

African-American women with breast cancer face significant disparities, including high levels of pain. Depressive symptoms and self-efficacy for pain management impact how women with breast cancer manage pain, yet little is known about how these variables relate to pain specifically for African-American women with breast cancer.

Methods

Baseline linear regression analyses were conducted using a sample of women (n = 98) with stage I–III breast cancer identifying as Black or African-American who were part of a larger intervention trial. Linear regressions explored the effect of depressive symptoms on pain (i.e., severity and interference), and the effect of self-efficacy for pain management on pain. Covariates were age (M = 57.22, SD = 10.76), cancer stage (50% = stage 1), and education level (36% = some college).

Results

Participants reported moderate levels of pain severity and interference. Higher depressive symptoms were related to both higher pain severity and interference; (B = 0.06, p < 0.01, 95% CI [0.02,0.09]) and (B = 0.13, p < 0.001, 95% CI [0.09, 0.17]) respectively. Likewise, lower self-efficacy for pain management was also related to both higher pain severity and interference; (B =  − 0.04, p < 0.001, 95% CI [− 0.05, − 0.02]) and (B =  − 0.06, p < 0.001, 95% CI [− 0.08, − 0.04]) respectively. Women reporting less than a high school diploma endorsed significantly higher pain severity and interference than women reporting some college. Age and cancer stage were not significantly related to pain.

Conclusion

Pain for African-American women with breast cancer may be influenced by depressive symptoms and self-efficacy for pain management, in addition to other important variables. Attending to better assessment and treatment of depressive symptoms and self-efficacy for pain management may improve outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Data availability

N/A.

Code availability

N/A.

References

  1. DeSantis CE, Ma J, Gaudet MM et al (2019) Breast cancer statistics, 2019. CA Cancer J Clin 69:438–451

    Article  PubMed  Google Scholar 

  2. Yedjou CG, Tchounwou PB, Payton M et al (2017) Assessing the racial and ethnic disparities in breast cancer mortality in the United States. Int J Environ Res Public Health 14:E486

    Article  PubMed  CAS  Google Scholar 

  3. Green C, Hart-Johnson T, Loeffler D (2011) Cancer-related chronic pain: examining quality of life in diverse cancer survivors. Cancer 117:1994–2003

    Article  PubMed  Google Scholar 

  4. van den Beuken-van Everdingenvan den M, de Rijke J, Kessels A, Schouten A, van Kleef M, Patijn J (2007) Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol. 18:1437–1449

    Article  Google Scholar 

  5. Shi Q, Smith TG, Michonski JD, Stein KD, Kaw C, Cleeland CS (2011) Symptom burden in cancer survivors 1 year after diagnosis: a report from the American Cancer Society’s Studies of Cancer Survivors. Cancer 117:2779–2790

    Article  PubMed  Google Scholar 

  6. Maly A, Singh N, Vallerand AH (2018) Experiences of urban African Americans with cancer pain. Pain Manag Nurs 19:72–78

    Article  PubMed  PubMed Central  Google Scholar 

  7. Coughlin SS, Yoo W, Whitehead MS, Smith SA (2015) Advancing breast cancer survivorship among African-American women. Breast Cancer Res Treat 153:253–261

    Article  PubMed  PubMed Central  Google Scholar 

  8. Meghani SH, Polomano RC, Tait RC, Vallerand AH, Anderson KO, Gallagher RM (2012) Advancing a national agenda to eliminate disparities in pain care: directions for health policy, education, practice, and research. Pain Med 13:5–28

    Article  PubMed  Google Scholar 

  9. Williams F, Thompson E (2017) Disparities in breast cancer stage at diagnosis: importance of race, poverty, and age. J Health Dispar Res Pract 10:34–45

    PubMed  PubMed Central  Google Scholar 

  10. McGee SA, Durham DD, Tse C-K, Millikan RC (2013) Determinants of breast cancer treatment delay differ for African American and White women. Cancer Epidemiol Biomarkers Prev 22:1227–1238

    Article  PubMed  PubMed Central  Google Scholar 

  11. Siddharth S, Sharma D (2018) Racial disparity and triple-negative breast cancer in African-American women: a multifaceted affair between obesity, biology, and socioeconomic determinants. Cancers (Basel) 10:514

    Article  CAS  Google Scholar 

  12. Tammemagi CM (2007) Racial/ethnic disparities in breast and gynecologic cancer treatment and outcomes. Curr Opin Obstet Gynecol 19:31–36

    Article  PubMed  Google Scholar 

  13. Sun V, Borneman T, Piper B, Koczywas M, Ferrell B (2008) Barriers to pain assessment and management in cancer survivorship. J Cancer Surviv 2:65–71

    Article  PubMed  PubMed Central  Google Scholar 

  14. Hoffman KM, Trawalter S, Axt JR, Oliver MN (2016) Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. PNAS 113:4296–4301

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Bulls HW, Chu E, Goodin BR et al (2022) Framework for opioid stigma in cancer pain. Pain 163:e182–e189

    Article  PubMed  Google Scholar 

  16. Yeager KA, Williams B, Bai J et al (2019) Factors related to adherence to opioids in Black patients with cancer pain. J Pain Symptom Manag 57:28–36

    Article  Google Scholar 

  17. Brandão T, Schulz MS, Matos PM (2017) Psychological adjustment after breast cancer: a systematic review of longitudinal studies. Psychooncology 26:917–926

    Article  PubMed  Google Scholar 

  18. Onitilo AA, Nietert PJ, Egede LE (2006) Effect of depression on all-cause mortality in adults with cancer and differential effects by cancer site. Gen Hosp Psychiatry 28:396–402

    Article  PubMed  Google Scholar 

  19. Cheruvu VK, Oancea SC (2016) Current depression as a potential barrier to health care utilization in adult cancer survivors. Cancer Epidemiol 44:132–137

    Article  PubMed  Google Scholar 

  20. Sheppard VB, Llanos AA, de Mendoza AH, Taylor TR, Adams-Campbell LL (2013) Correlates of depressive symptomatology in African American breast cancer patients. J Cancer Surviv 7:292–299

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kang Y, Meghani SH, Bruner DW, Yeager KA (2020) Factors associated with depression in African American patients being treated for cancer pain. Pain Manag Nurs 21:410–415

    Article  PubMed  PubMed Central  Google Scholar 

  22. Hamilton JB, Deal AM, Moore AD, Best NC, Galbraith KV, Muss H (2013) Psychosocial predictors of depression among older African American cancer patients. Oncol Nurs Forum 40:394–402

    Article  PubMed  PubMed Central  Google Scholar 

  23. Sheppard VB, Llanos AA, Hurtado-de-Mendoza A, Taylor TR, Adams-Campbell LL (2013) Correlates of depressive symptomatology in African-American breast cancer patients. J Cancer Surviv 7:292–299

    Article  PubMed  PubMed Central  Google Scholar 

  24. Bamonti P, Moye J, Naik A (2018) Pain is associated with continuing depression in cancer survivors. Psychol Health Med 23:1–14

    Article  Google Scholar 

  25. Shi Q, Michonski J, Stein K, Kaw C, Cleeland C (2011) Symptom burden in cancer survivors 1 year after diagnosis: a report from the American Cancer Society’s Studies of Cancer Survivors. Cancer 117:2779–2790

    Article  PubMed  Google Scholar 

  26. White LL, Cohen MZ, Berger AM, Kupzyk KA, Bierman PJ (2019) Self-efficacy for management of symptoms and symptom distress in adults with cancer: an integrative review. Oncol Nurs Forum 46:113–128

    PubMed  Google Scholar 

  27. Somers TJ, Kelleher SA, Westbrook KW et al (2016) A small randomized controlled pilot trial comparing mobile and traditional pain coping skills training protocols for cancer patients with pain. Pain Res Treat 2016:2473629

  28. Sheppard VB, Harper FWK, Davis K, Hirpa F, Makambi K (2014) The importance of contextual factors and age in association with anxiety and depression in Black breast cancer patients. Psychooncology 23:143–150

    Article  PubMed  Google Scholar 

  29. Watkins CC, Kamara Kanu I, Hamilton JB, Kozachik SL, Gaston-Johansson F (2017) Differences in coping among African American women with breast cancer and triple-negative breast cancer. Oncol Nurs Forum 44:689–702

    Article  PubMed  Google Scholar 

  30. Kelleher SA, Dorfman CS, Plumb Vilardaga JC et al (2017) Optimizing delivery of a behavioral pain intervention in cancer patients using a sequential multiple assignment randomized trial SMART. Contemp Clin Trials 57:51–57

    Article  PubMed  PubMed Central  Google Scholar 

  31. Fisher HM, Winger JG, Miller SN et al (2021) Relationship between social support, physical symptoms, and depression in women with breast cancer and pain. Support Care Cancer 29:5513–5521

    Article  PubMed  PubMed Central  Google Scholar 

  32. Cleeland C, Ryan K (1995) Pain assessment: global use of the Brief Pain Inventory. Rehabil Oncol 1995(13):29–30

    Google Scholar 

  33. Carleton RN, Thibodeau MA, Teale MJN et al (2013) The center for epidemiologic studies depression scale: a review with a theoretical and empirical examination of item content and factor structure. PLoS ONE 8:e58067

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Anderson KO, Dowds BN, Pelletz RE, Edwards TW, Peeters-Asdourian C (1995) Development and initial validation of a scale to measure self-efficacy beliefs in patients with chronic pain. Pain 63:77–83

    Article  PubMed  Google Scholar 

  35. George D, Mallery M (2010) SPSS for Windows step by step: a simple guide and reference, 17.0 update, 10th edn. Pearson, Boston

    Google Scholar 

  36. Yee MK, Sereika SM, Bender CM, Brufsky AM, Connolly MC, Rosenzweig MQ (2017) Symptom incidence, distress, cancer-related distress, and adherence to chemotherapy among African American women with breast cancer. Cancer 123:2061–2069

    Article  CAS  PubMed  Google Scholar 

  37. Kelleher SA, Fisher HM, Winger JG et al (2021) Feasibility, engagement, and acceptability of a behavioral pain management intervention for colorectal cancer survivors with pain and psychological distress: data from a pilot randomized controlled trial. Support Care Cancer 29:5361–5369

    Article  PubMed  Google Scholar 

  38. Dorfman CS, Kelleher SA, Winger JG et al (2019) Development and pilot testing of an mHealth behavioral cancer pain protocol for medically underserved communities. J Psychosoc Oncol 37:335–349

    Article  PubMed  Google Scholar 

  39. Vallerand AH, Templin TN, Hasenau SM, Maly A (2019) Modifiable pathways from pain to functional status: confirmatory baseline results from a randomised trial of African American patients with cancer pain. Eur J Cancer Care 28:e12994

    Article  Google Scholar 

  40. Keefe FJ, Abernethy AP, Campbell LC (2005) Psychological approaches to understanding and treating disease-related pain. Annu Rev Psychol 56:601–630

    Article  PubMed  Google Scholar 

  41. Polite BN, Adams-Campbell LL, Brawley OW et al (2017) Charting the future of cancer health disparities research: a position statement from the American Association for Cancer Research, the American Cancer Society, the American Society of Clinical Oncology, and the National Cancer Institute. Cancer Res 77:4548–4555

    Article  CAS  PubMed  Google Scholar 

  42. Andersen KG, Kehlet H (2011) Persistent pain after breast cancer treatment: a critical review of risk factors and strategies for prevention. J Pain 12:725–746

    Article  PubMed  Google Scholar 

  43. Bai J, Brubaker A, Meghani SH, Bruner DW, Yeager KA (2018) Spirituality and quality of life in Black patients with cancer pain. J Pain Symptom Manage 56:390–398

    Article  PubMed  Google Scholar 

  44. Whitehead NE, Hearn LE (2015) Psychosocial interventions addressing the needs of Black women diagnosed with breast cancer: a review of the current landscape. Psychooncology 24:497–507

    Article  PubMed  Google Scholar 

Download references

Funding

This study was funded through an NIH/NCI 1R01CA202779-01 awarded to senior author, Tamara J. Somers, PhD. The work of Jennifer C. Plumb Vilardaga, PhD, was supported in part by a Career Development Award through the Duke University REACH Equity Center; funded by the National Institute on Minority Health and Health Disparities (5U54MD012530-04). The work of Joseph G. Winger, Ph.D., was supported in part by a Kornfeld Scholars Program Award from the National Palliative Care Research Center.

Author information

Authors and Affiliations

  1. Duke University Medical Center, Pain Prevention and Treatment Research Program, 2400, Pratt Street, 7th Floor, Durham, NC, 27705, USA

    Jennifer C. Plumb Vilardaga, Hannah M. Fisher, Joseph G. Winger, Shannon N. Miller, Catherine Majestic, Sarah A. Kelleher & Tamara J. Somers

  2. University of Miami Miller School of Medicine, Miami, FL, USA

    Christine Nuñez

Authors
  1. Jennifer C. Plumb Vilardaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hannah M. Fisher
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joseph G. Winger
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shannon N. Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christine Nuñez
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Catherine Majestic
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sarah A. Kelleher
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tamara J. Somers
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, recruitment, delivery of study intervention, and data collection were performed by Jennifer C. Plumb Vilardaga, PhD, Hannah M. Fisher, PhD, Joseph G. Winger, PhD, Shannon N. Miller, BPH, Christine Nuñez, BA, Catherine Majestic, PhD, Sarah A. Kelleher, PhD, and Tamara J. Somers, PhD. Data analyses were performed by Hannah M. Fisher, Ph.D. The first draft of the manuscript was written by Jennifer C. Plumb Vilardaga, Ph.D., and all authors commented on subsequent versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jennifer C. Plumb Vilardaga.

Ethics declarations

Ethics approval

Procedures complied with ethical guidelines and received Duke University Institutional Review Board approval (Pro00070823).

Consent to participate

Informed consent was obtained from all individual participants included in this study.

Consent for publication

The authors affirm that all human research participants provided informed consent for publication of the data included in this publication.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vilardaga, J.C.P., Fisher, H.M., Winger, J.G. et al. Pain, depressive symptoms, and self-efficacy for pain management: examination in African-American women with breast cancer. Support Care Cancer 30, 6633–6640 (2022). https://doi.org/10.1007/s00520-022-07083-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-022-07083-6

Keywords

Search

Navigation