(179) - Pain interference is associated with diabetes distress in a sample of african american older adults

Abstract

African American adults are at greater risk than their White counterparts for poor diabetes outcomes as well as under-treatment of chronic pain and pain-related disability. Studies indicate that diabetes patients with chronic pain have poorer self-management behaviors and worse glycemic control. Chronic pain adversely affects psychosocial functioning and may therefore also exacerbate diabetes distress (i.e., emotional distress and burden linked to diabetes and its management; Fisher et al, 2010). To our knowledge, this association has not previously been evaluated. Using baseline survey data from 93 participants (mean age = 65 years; 98% African American) participating in a study of church-based diabetes self-management support (“PRAISE”), we tested our hypothesis that participants with greater pain interference would have higher diabetes distress across domains. We identified participants who reported that pain interfered with their normal work/housework “moderately”, “quite a bit” or “extremely” in the last 4 weeks (Medical Outcomes Study, 1995). Participants rated 17 items on the Diabetes Distress Scale (1 = not a problem to 6 = very serious problem; Polonsky et al., 2005) in four domains: Emotional Burden, Physician-related, Regimen-related, and Interpersonal. Overall, 43% of PRAISE participants (n = 40) reported at least moderate pain interference in the last week. These participants had higher overall (2.1 vs. 1.7; p = .004), emotional (2.4 vs. 1.8; p = .006) and physician-related (1.7 vs. 1.2; p = .004) diabetes distress than participants with little/no pain interference. Post-hoc analysis revealed that these associations were strongest in adults over 65 years. Findings suggest the possible value of addressing management of chronic pain as part of diabetes-management support programs.