A Comparative Study of Pain Intensity, Information Seeking, and Adjustment to Prostate Cancer in Japanese American and European American Men

Mildred Kowalski, Doctor of Philosophy, 2007 Major: Nursing, at the College of Dentistry, New York University Title of Dissertation: A Comparative Study of Pain Intensity, Information-Seeking, and Adjustment to Prostate Cancer in Japanese American Men and European American Men Directed by: Judith Haber ABSTRACT Adjustment to illness is a multi-dimensional and difficult process for many patients facing a life-threatening illness, such as prostate cancer. Adjustment encompasses changes in social interactions, physical limitations and role function (Germino et al., 1998; Hoskins et ah, 1996). Information-seeking and the reporting of pain promote adjustment and are explained by the Roy Adaptation Model (Boston Based Adaptation Research in Nursing Society, 1999); which was used as a framework for this study. As the United States becomes more ethnically diverse, nurses are challenged to care for patients from different ethnic backgrounds. The purpose o f this descriptive study was to explore ethnic differences in self-reporting of pain (Brief Pain Inventory, BPI; Cleeland & Ryan, 1994), information-seeking behavior (Krantz Health Opinion Survey, KHOS; Krantz et ah, 1980) and adjustment (Psychosocial Adjustment Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. to Illness Scale, PAIS; Derogatis & Derogatis, 1990), in Japanese American and European American men, treated for prostate cancer. Data from 89 consenting participants, 12 Japanese American and 78 European American men, were analyzed using Wilcoxon Rank Sum. The median age was 70. Most participants were married, protestant and college graduates. The ethnic groups were will-matched for age, marital status, number of children, highest education level and income. The most common treatments for prostate cancer reported were androgen deprivation therapy (65%), surgery (55%), and radiation (53%). Because three comparisons were performed on the same dataset, a Bonforroni adjustment for significance level was used. The significance level was set at/? 017 (.05/3), to detect an alpha of . 05. Wilcoxon Rank Sum analysis was performed for each of three main comparisons: 1) information-seeking (KHOS), 2) self-reported pain (BPI), and 3) overall adjustment to illness (PAIS). A difference for information-seeking (KHOS) between the Japanese American and European American groups,/? = . 012, was observed. Overall, information-seeking (i.e. inquisitiveness) correlated with better adjustment (p = 0.006). No differences were seen in overall adjustment or self-reported severity of pain. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. The results of this study support ethnic differences in information-seeking patterns observed by other researchers (KagawaSinger, 1988; Kakai et al., 2003), and provide insight for nurses to better care for patients across ethnic groups. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Copyright © Mildred Ortu Kowalski Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.