Showing papers by "Sonia M. Davis published in 2016"

Machismo, marianismo, and negative cognitive-emotional factors: Findings from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study.

Abstract: There is limited research on the traditional Hispanic male and female gender roles of machismo and marianismo, respectively, in relation to negative cognitions and emotions. Given the vulnerability of Hispanics to negative cognitions and emotions, it is important to examine sociocultural correlates of emotional distress. Therefore, we examined associations of machismo and marianismo with negative cognitive-emotional factors (i.e., depression symptoms; cynical hostility; and trait anxiety and anger) in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study, a cross-sectional cohort study of sociocultural and psychosocial correlates of cardiometabolic health. Participants were aged 18-74 years and self-identified as Hispanic of Central American, Cuban, Dominican, Mexican, Puerto Rican, South American, and other Hispanic background (N = 4,426). Results revealed that specific components of machismo (traditional machismo) and marianismo (family and spiritual pillar dimensions) were associated with higher levels of negative cognitions and emotions after adjusting for socio-demographic factors (p < .05); these associations remained consistent across sex, Hispanic background group, and acculturation. Findings can inform mental health interventions and contribute to our understanding of the importance of gender role socialization in the context of self-reported negative cognitive-emotional factors in Hispanics.

Development and Validation of a Brief Interactive Educational Video to Improve Outpatient Treatment of Older Adults' Acute Musculoskeletal Pain

Abstract: To the Editor: Acute musculoskeletal pain is a common reason for emergency department (ED) visits, and pain that is not properly treated can become chronic. Most individuals in the ED with musculoskeletal pain are discharged home, leaving them responsible for decisions regarding pain management. Because commonly used pain medications have considerable risks and frequently cause side effects for older adults, education before discharge is important. A brief video has the potential to provide this education in a consistent, accessible manner without requiring time from medical providers. To meet this need, a brief educational video that presents information about the pharmacological and nonpharmacological management of acute musculoskeletal pain was developed and tested. Content for the video was based on a review of the literature and current guidelines and input from experts in emergency medicine, geriatrics, pharmacology, physical therapy, and risk communication. The initial script was modified after feedback was received from 10 individuals in the ED aged 50 and older. A professional actress wearing a laboratory coat narrates the video, which includes graphics and important points displayed in writing; the reading level for the spoken content is 8.6 based on the Flesch-Kincaid readability test. The video contains four sections: acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and nonpharmacological behaviors. For each pharmacological treatment, information includes common generic and trade names, indications, contraindications, recommended doses, and side effects. The nonpharmacological behaviors include physical activity, sleep, social support, and relaxation. Each section concludes with one multiple-choice question to promote viewer interaction and reinforce learning. The final version, the “Brief Educational Tool to Enhance Recovery from Pain” (BETTER from Pain), can be accessed on-line (https://media.med.unc.edu/emergmed/better/index.html). The effect of the video on patient knowledge and preparedness and confidence to treat pain was evaluated in a pilot study of 40 individuals aged 50 and older who presented to an ED in the southeastern United States with a chief complaint of musculoskeletal pain. Individuals were excluded if they were unable to read and understand English, were critically ill as defined by a triage score of 1 on the emergency severity index or the judgment of the treating physician, or had cognitive impairment as defined according to a Six-Item Screener score less than 4. Before and after viewing the video, knowledge about pain medications was assessed using 14 multiple-choice questions, and preparedness and confidence to treat pain at home were assessed using six questions with responses on a 5-point Likert scale (Appendix S1). Eight of the knowledge questions were adapted from a knowledge assessment for individuals with osteoarthritis. The local institutional review board approved all study procedures, and verbal informed consent was obtained from all participants. The percentage of correct answers was calculated for all knowledge questions and knowledge question subgroups (general treatment, acetaminophen, NSAIDs, opioids); average preparedness and confidence scores were calculated by treating the 5-point Likert scales as numeric values. Before and after scores were compared using the Wilcoxon signed-rank test. Scores were also assessed separately for younger (50–64) and older (≥65) individuals. A sample size of 20 individuals per age group provided 80% power to detect a mean increase of 2 points in knowledge scores, assuming a standard deviation of 3 points for change in score, using a two-sided alpha of .05. It was subsequently decided to present results as percentage correct. Of 53 individuals in the ED who were screened, 44 were eligible, and 40 (91%) consented to participate. Average time spent viewing the video was 13 minutes (range 8–18 minutes). Overall, 98% demonstrated improved knowledge after watching the video; average percentage of questions answered correctly increased from