@article{e276e20bf3d64b0fa72eaebf6b85beb7,
title = "A Comparison of Rural and Urban Hospice Family Caregivers' Cancer Pain Knowledge and Experience",
abstract = "Context: Family caregivers play a vital role in managing the pain of hospice patients with cancer; however, caregivers' knowledge of pain management principles and experiences as pain managers vary widely. Differences in cultural values and access to resources suggest that rural and urban hospice family caregivers may differ with regard to their pain knowledge and experience, but this has not been empirically investigated. Objectives: We sought to determine if rural and urban hospice family caregivers differed in terms of their knowledge of cancer pain management principles and their experiences managing cancer pain. Methods: Our study consisted of a secondary analysis of baseline, cross-sectional data from hospice family caregivers (N = 196) participating in an ongoing cluster randomized crossover pragmatic trial. We performed multivariable regression to model associations between caregivers' demographic characteristics and their scores on the Family Pain Questionnaire (FPQ), which included subscales measuring pain knowledge and experience. Results: When controlling for other demographic variables, rural caregivers' scores on the FPQ knowledge subscale were worse (P = 0.01) than their urban counterparts. FPQ experience subscale scores and FPQ total scores were not statistically significantly different between the two groups. Conclusion: Rural hospice family caregivers report greater pain knowledge deficits than urban hospice family caregivers, although the two groups report comparable pain management experiences. Additional research is needed to better explain observed differences.",
keywords = "Cancer, caregivers, hospice care, pain, rural, urban",
author = "Washington, {Karla T.} and Oliver, {Debra Parker} and Smith, {Jamie B.} and Kruse, {Robin L.} and Meghani, {Salimah H.} and George Demiris",
note = "Funding Information: This work was supported by the National Cancer Institute of the National Institutes of Health ( R01CA203999 ; principal investigator: Parker Oliver). The content of this article is solely the responsibility of its authors and may not necessarily reflect the official views of the study's funder. The authors thank the family caregivers who volunteered to participate in this research and the hospice professionals who assisted in identifying potential study participants. The authors also gratefully acknowledge the contributions of Megan J. Mooney, MSW, Christina M. Merrick, MA, and Lucas A. Jorgensen, BA, who oversaw participant recruitment and data collection and management. Funding Information: All research activities were conducted as a substudy of an ongoing cluster randomized crossover pragmatic trial sponsored by the National Cancer Institute (R01CA203999; henceforth referred to as the ?parent trial?). The parent trial was approved by leadership of the participating hospice agencies and the University of Missouri Institutional Review Board (#2006270). The full study protocol is registered at clinicaltrials.gov (NCT02929108). Study participants were adult FCGs of adult patients with cancer who were receiving services from one of six hospice agencies in the Midwestern United States. FCGs were recruited into the parent trial as close as possible to the date of their patient's hospice enrollment; most (74%) joined the study within two weeks of the hospice enrollment date.This work was supported by the National Cancer Institute of the National Institutes of Health (R01CA203999; principal investigator: Parker Oliver). The content of this article is solely the responsibility of its authors and may not necessarily reflect the official views of the study's funder. The authors thank the family caregivers who volunteered to participate in this research and the hospice professionals who assisted in identifying potential study participants. The authors also gratefully acknowledge the contributions of Megan J. Mooney, MSW, Christina M. Merrick, MA, and Lucas A. Jorgensen, BA, who oversaw participant recruitment and data collection and management. Publisher Copyright: {\textcopyright} 2019 American Academy of Hospice and Palliative Medicine",
year = "2019",
month = oct,
doi = "10.1016/j.jpainsymman.2019.07.010",
language = "English",
volume = "58",
pages = "685--689",
journal = "Journal of Pain and Symptom Management",
issn = "0885-3924",
number = "4",
}