| Negative beliefs about pain management can be barriers to optimal pain control for adolescents with cancer. The purpose of this dissertation was to increase understanding of barriers to pain management among adolescents with cancer. The framework was Ward and colleagues' barriers model which proposes that barriers influence coping, which, in turn, affects outcomes. The specific aims were to examine the reliability and validity of the Adolescent Barriers Questionnaire (ABQ), to describe barriers, and to explore the relationships between gender and age and model variables.; Participants were 32 girls and 28 boys, ranging in age from 12 to 17 years. Twenty-two of the participants reported experiencing pain in the past month. Most received cancer care in Wisconsin and from pediatric oncology clinics. Internal consistency for the ABQ was 0.91, and test-retest reliability was r = 0.82. The mean (SD) ABQ total was 1.62 (0.74). Barrier scores did not differ by age, gender, or disease-related variables.; Data from the 22 participants who reported pain in the past month were used in the tests of the barriers model. The model proposes that coping mediates the relationship between barriers and outcomes. Because no females were categorized as being adequately medicated, PMI was not tested as a mediator when data were used from male and female participants. As predicted, barriers were significantly associated with hesitation to use analgesics and report pain, however hesitation did not function as a mediator between barriers and any of the outcomes. When data from the males only were tested, neither Hesitation nor adequacy of analgesics functioned as a mediator between barriers and outcomes.; No significant differences were found between age and gender on hesitation, pain severity, physical or psychosocial function. For adequacy of analgesia, compared to the proportion of males, a significantly greater proportion of females were undermedicated.; Contributions of this dissertation included examining barriers to pain management in a systematic way and testing hypothesized relationships for the first time among adolescents with cancer. These findings demonstrate links between adolescent barriers and hesitation to report pain and use analgesics and suggest that barriers among adolescents with cancer should be addressed. |
