(982) Ethnic differences in pain and other symptoms associ-ated with blood or marrow transplantations

M. Cohen, T. Mendoza, I. Gning, J. Neumann, S. Giralt, C. Cleeland; Universityof Texas Health Science Center and M.D Anderson Cancer Center, Houston, TXBMT (Blood and marrow transplantation) is widely used and leads to avariety of severe symptoms. As with other cancer treatments, patients’survival and treatment effectiveness are linked with effective symptommanagement. Virtually no literature has examined African American orHispanic experiences or symptoms with BMT, and little BMT research hasbeen longitudinal. A recently completed study included the aim of eval-uating the relationship of symptoms, functional status, and quality oflife at multiple time points over the course of the BMT experience inthese ethnic groups. The goals of this longitudinal study are to examineethnic differences in pain and symptom report and to determine therelationships between symptoms, functional status and quality of life ofpatients during the first 100 days post-transplantation. Sixty-two pa-tients (24 African-Americans and 38 Hispanics) completed the BMT mod-ule of the M.D. Anderson Symptom Inventory (MDASI) and the Func-tional Assessment of Cancer Therapy-Bone Marrow Transplantation(FACT-BMT) at baseline and seven more times during the first 100 dayspost-transplantation. The patients’ performance status was also re-corded. There were no significant differences in symptom severity,symptom interference, quality of life and ECOG performance status be-tween Hispanics and African-Americans over time. Pain was reported tobe severe in 10 to 23% of patients over time. There were significantdifferences in symptom severity, symptom interference and ECOG per-formance status across time in both groups. These measures graduallyincreased starting from baseline, reached their maximum at T4 (whenwhite blood cell counts were at nadir) and then started to decline. Therewere no significant differences in quality of life between ethnic groups.Changes in symptom interference are significantly correlated withchanges in quality of life. Symptom interference for patients undergo-ing BMT was more closely related to quality of life than was symptomseverity.

(983) Individual differences in chronic pain and disease inolder blacks: The role of psychosocial factors

T. Baker; University of Michigan, Ann Arbor, MIThe literature documents the differential impact of chronic pain on thephysical, psychological, and social well-being among Whites. However,the impact of chronic pain among Blacks has not been extensively inves-tigated. Furthermore, this population is extremely diverse with consid-erable historical, social, economic, and health differences. Thus, we hy-pothesized that there were significant within group differences in thechronic pain experience among Blacks. This study sought to determinethe association of specific demographic (e.g., age, gender, education,income) and health factors (independently and collectively) to pain in-tensity, and to determine the amount of unique variance in pain inten-sity accounted for by various psychological and social factors in a sampleof older Blacks. The sample consisted of community-dwelling Blacks (N �189) greater than 50 years of age from several senior citizen housingfacilities. Participants had a mean age of 69.8 � 9.12 years. The majority(77%) of the respondents were women. Results showed that reportingmore depressive symptoms and physical disability, and being youngerwere significant indicators of pain intensity and accounted for 28% (Adj.R2 � .22) of its variation. We established that younger Blacks, those whoreported more depressive symptoms and decreased physical functioningalso reported greater pain intensity. This and other investigations ex-ploring pain indicators within defined racial and ethnic groups are nec-essary for developing a body of knowledge that will yield more mean-ingful and valid comparisons and inferences between different groups.These research efforts would provide a scientific basis for understandingthe physical and psychological implications of pain among Blacks. Moreimportantly, these initiatives would help develop models that assesshow social, cultural, and environmental factors influence the daily ex-perience of pain among adults from racial and ethnically diverse popu-lations.

(984) Racial group differences in chronic pain treatment out-comes

R. Young, M. Clark, R. Gironda; James A. Haley VAMC, Tampa, FLThe relationship between race and chronic pain treatment outcomeswas investigated in a sample of 712 veterans receiving treatment at oneof six Veterans’ Administration medical centers located in California,Florida, and Puerto Rico. Multivariate and covariate analyses of variancewere used to analyze pain intensity and Pain Outcomes Questionnaire –VA (POQ-VA) scale scores prior to the onset of treatment (intake) and attreatment termination (discharge). Consistent with prior research find-ings, at intake Hispanic and African Americans’ pain intensity ratingswere not significantly different but both minority groups’ ratings weresignificantly higher than Caucasians. Both minority groups also demon-strated higher intake POQ-VA scale scores than Caucasians. AfricanAmericans scored higher than Caucasians on four of five POQ-VA scalesand Hispanics scored higher than Caucasians on all five POQ-VA scales.Additionally Hispanics reported significantly more negative affect atintake than African Americans. By contrast, at discharge only a singlesignificant difference was found between the three racial groups. Usingadjusted means, Hispanics demonstrated proportionally less treatmentrelated change when compared with Caucasians (but not African Amer-icans) on a measure of pain related impairment in completing activitiesof daily living. Results are considered within the context of the existingresearch literature and implications for their importance in chronic paintreatment are discussed.

F30 - Other(985) A comparison of anticipated and actual surgical painD. Chang, W. Lee, S. Barlas, M. Hale, D. Jones, R. Kamath, A. Morse, R. Strain,P. Reddy, S. Mockoviak, P. Duong; Merck & Co., Inc., West Point, PAThe objective of this analysis was to compare anticipated pain prior tosurgery with actual pain experienced postoperatively by patients under-going outpatient surgical arthroscopic knee procedures. In a prospectivemulticenter study, patients undergoing knee arthroscopy reported theiranticipated pain prior to surgery. Actual pain was recorded by the pa-tients at the time of discharge and on the evening of surgery, at whichtime they assessed their worst pain and average pain since the surgery.Pain was measured on a visual analog scale (0�none to 10�worst pain).The anticipated pain and actual pain were compared with a pairedstudent t-test. Using the difference in the actual pain and the antici-pated pain measure as a dependent variable, three multiple regressionswere performed where anticipated pain intensity, age, gender, ethnic-ity, education, and surgery duration were used as predictors. Forty-twopatients enrolled in the study. The mean age was 45.8 years, 54.8% werefemale, 69% were white, and 37% had a high school education or less.The mean duration of surgery was 28 minutes. The pre-surgery antici-pated pain was 6.0 �2.1 (mean�SD); the actual pain was 2.5�2.8, 4.3�2.4 and 5.7 �2.7 for discharge pain, average pain, and worst pain,respectively. The t-tests indicated that discharge pain and average painwere significantly different from anticipated pain (p�0.05). On the con-trary, the worst pain was in a close agreement with the anticipated pain(p�0.57). Although the worst pain reported may be closest to the antic-ipated pain reported, there is still a considerable gap in the anticipationof pain which may create an additional psychological burden on thepatients.

104 Abstracts