title: Decision Support Preferences Among Hispanic and Non-Hispanic White Older Adults With Chronic Musculoskeletal Pain.
abstract: Despite broad recognition that social networks play a key role in the management of chronic musculoskeletal pain (CMP), little is known about when and why older adults with CMP choose to involve others in treatment decisions. This study investigates the types (i.e., informational, emotional, and instrumental) and sources (i.e., formal and informal) of support Hispanic and non-Hispanic White CMP patients desire and receive when making decisions about their pain care.
  
  
  
  Semi-structured interviews were conducted with Hispanic and non-Hispanic White older adults with CMP (N = 63) recruited from one medical center and one senior center in New York City. Interviews were transcribed and then analyzed using content analysis.
  
  
  
  CMP patients sought network members who supported their emotional well-being throughout the decision-making process. When considering high-stakes treatment decisions, participants selectively involved individuals who had similar pain conditions or first-hand experience with the procedure. Participants' perceptions of the decision-making process were contingent upon the congruence between the decision they made and the support they received for it. For Spanish-speaking participants, positive perceptions were linked with satisfactory language competence by their providers. On the other hand, lack of language competence among providers hindered Spanish speakers' ability to obtain adequate informational support.
  
  
  
  Results reveal the importance of empathic patient-provider exchanges across diverse patient populations and cultural sensitivity for Spanish-speaking patients. Findings suggest that social networks beyond the patient-provider dyad influence patients' decision-making satisfaction.
authors: Department of Human Development, Cornell University, Ithaca, New York. cr347@cornell.edu.
authors: Catherine
authors: C
authors: Riffin
authors: Department of Human Development, Cornell University, Ithaca, New York.
authors: Karl
authors: K
authors: Pillemer
authors: Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York.
authors: Manny C
authors: MC
authors: Reid
authors: Department of Human Development, Cornell University, Ithaca, New York.
authors: Corinna E
authors: CE
authors: Lӧckenhoff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D065246:Culturally Competent Care; D003657:Decision Making; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000628:therapy*; D009519:New York City / Q000208:ethnology; D057240:Patient Preference / Q000208:ethnology*; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012944:Social Support; D044465:White People / Q000208:ethnology*
keywords: Decision making; Pain management; Qualitative content analysis; Social networks