Abstract：
Individuals living with cancer and survivors of cancer who self-identify as Hispanic experience higher pain burden and greater barriers to pain management compared with their non-Hispanic counterparts. The Society for Integrative Oncology-ASCO guideline recommends acupuncture and massage for cancer pain management. However, Hispanic individuals\' expectations about these modalities remain under-studied and highlight a potential barrier to treatment utilization in this population. We conducted a subgroup analysis of baseline data from two randomized clinical trials to evaluate ethnic differences in treatment expectations about integrative pain treatment modalities among Hispanic and non-Hispanic cancer patients and survivors of cancer. The Mao Expectancy of Treatment Effects (METE) instrument was used to measure treatment expectancy for electro-acupuncture, auricular acupuncture, and massage therapy. Results of this study demonstrated that Hispanic participants reported greater expectation of benefit from electroacupuncture, auricular acupuncture, and massage (all P < 0.01). After controlling for age, gender, race, and education, Hispanic ethnicity remained significantly associated with greater expectation of benefit from integrative therapies for pain (coef.=1.47, 95% CI, 0.67-2.27). Non-white race (coef.=1.04, 95% CI, 0.42-1.65), no college education (coef.=1.16, 95% CI, 0.59-1.74), and female gender (coef.=0.94, 95% CI, 0.38-1.50) were also associated with a greater expectation of benefit from integrative therapies. Pain management should be informed by a shared decision-making approach that aligns treatment expectancy with treatment selections to optimize outcomes. Compared with non-Hispanic participants, Hispanic individuals reported higher expectation of benefit from acupuncture and massage, highlighting the potential role for integrative therapies in addressing ethnic pain disparities. Trial Registration NCT02979574 NCT04095234.
摘要：
与非西班牙裔同行相比，自我认同为西班牙裔的癌症患者和癌症幸存者经历了更高的疼痛负担和更大的疼痛管理障碍。综合肿瘤学会ASCO指南建议针灸和按摩治疗癌症疼痛。然而,西班牙裔人对这些方式的期望仍未得到充分研究，并强调了该人群中治疗利用的潜在障碍。我们对两项随机临床试验的基线数据进行了亚组分析，以评估西班牙裔和非西班牙裔癌症患者和癌症幸存者对综合疼痛治疗方式的治疗期望的种族差异。毛治疗效果预期（METE）仪器用于测量电针的治疗预期，耳针,和按摩疗法。这项研究的结果表明，西班牙裔参与者报告了更大的期望受益于电针，耳针,按摩(均P<0.01)。在控制了年龄之后,性别,种族,和教育，西班牙裔种族仍然与对疼痛综合疗法的益处的更高期望显着相关（coef。=1.47，95%CI，0.67-2.27）。非白人种族（coef。=1.04，95%CI，0.42-1.65），没有大学教育(coef.=1.16，95%CI，0.59-1.74），和女性性别(coef.=0.94，95%CI，0.38-1.50）也与更高的综合疗法获益预期相关。疼痛管理应通过共同的决策方法来告知，该方法将治疗预期与治疗选择相结合，以优化结果。与非西班牙裔参与者相比，西班牙裔人报告说，从针灸和按摩中获益的期望更高，强调综合疗法在解决种族疼痛差异方面的潜在作用。试用注册NCT02979574NCT04095234。
