title: Pain and Function in Home Care: A Need for Treatment Tailoring to Reduce Disparities?
abstract: To describe racial/ethnic group differences in pain presentation and the prevalence of psychosocial factors among patients admitted to home health care, and to determine the extent of racial/ethnic group differences in the association of psychosocial factors with pain intensity and pain-related disability.
  
  
  
  We analyzed cross-sectional data on 588 patients with activity-limiting pain admitted to home care for physical therapy. Three psychosocial factors were assessed: depressive symptoms, pain self-efficacy, and health literacy. Statistical methods included estimation of general linear models of pain intensity and pain-related disability.
  
  
  
  Hispanics and non-Hispanic blacks report a greater number of pain sites, worse pain intensity, and higher levels of pain-related disability than non-Hispanic whites and others. Racial/ethnic minority group patients also have a higher prevalence of adverse psychosocial factors than others, with evidence that race/ethnicity interacts with pain self-efficacy and depressive symptoms in their association with mean pain intensity and pain-related disability, respectively.
  
  
  
  The substantial racial/ethnic difference in the psychosocial profiles of older adults with activity-limiting pain highlights the importance of screening for these modifiable risk factors and tailoring interventions accordingly. Direct attention to the psychosocial needs of patients could help to address racial/ethnic disparities in pain outcomes.
authors: *Center for Home Care Policy & Research ‡Department of Compliance & Regulatory Affairs, Visiting Nurse Service of NY ∥Division of Geriatrics & Palliative Medicine, Weill Cornell Medical Center, New York †Department of Physical Therapy Education, SUNY Upstate Medical University, Syracuse §Department of Human Development, Cornell University, Ithaca, NY.
authors: Christopher M
authors: CM
authors: Murtaugh
authors: Katherine L
authors: KL
authors: Beissner
authors: Yolanda
authors: Y
authors: Barrón
authors: Melissa A
authors: MA
authors: Trachtenberg
authors: Eileen
authors: E
authors: Bach
authors: Charles R
authors: CR
authors: Henderson
authors: Sridevi
authors: S
authors: Sridharan
authors: Manny C
authors: MC
authors: Reid
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000208:ethnology; D004185:Disability Evaluation; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology*; D006699:Home Care Services; D006801:Humans; D008297:Male; D010146:Pain / Q000208:ethnology* / Q000523:psychology; D059408:Pain Management; D026741:Physical Therapy Modalities; D015995:Prevalence; D011446:Prospective Studies; D020377:Self Efficacy