Findings provide direction for enhancing independent older people's ability to manage chronic pain. The nine categories of barriers show direction for education of both clients and health care providers, as well as for planning other types of needed support. The theoretical model shows the complexity of barriers experienced by older adults with arthritis.

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Osteoporosis, a major health problem that increases with age, may lead to fractures and loss of independence. This study focused on testing a bone health intervention aimed at assisting older adults living independently in residential settings to maintain healthy bones with the long-term goals of fracture prevention and maintenance of independent function. Forty-seven participants (M (age) = 79.36 years) completed six 1-hour educational sessions. Pre-intervention testing of osteoporosis knowledge and healthy bone behaviors was followed by posttests at 1 week, 6 weeks, and 7(1/2) months. Findings revealed significant increases in knowledge and behaviors from baseline to 9(1/2) months, although a slight decline during the last 6 months when there was no reinforcement of learning suggests the need for periodic follow-up.

56 Background: Accreditation guidelines require all breast cancer patients receive SCPs within 6 months of end of treatment (EOT) in 2016. SCPs require significant resources to provide, which EHR assistance might decrease. Our objective was to develop a standardized program for creating, providing, and tracking SCPs using an EHR. Methods: Clinicians and EHR analysts developed processes for implementing an EHR-based program, using our existing SCP to guide overall structure. We piloted this program 5/2015-6/2015 to identify barriers & facilitators to creating EHR-based SCPs, providing EHR-based visits and EHR-based tracking of both. Results: The pilot included 24 patients (2% of annual volume). Facilitators were: 1) pre-entry of cancer history, 2) clearly defined responsibilities for SCP & visit; barriers were: 3) no identified method to assess concerns or track referrals, 4) variability in EOT due to treatment heterogeneity, 5) limited time during routine follow up for SCP provision. The following changes were implemented: 1) SCP auto-population, requiring consensus on essential clinical data, 2) assigning staff roles (MD, NP/PA, RN) for all aspects of SCP creation & visit provision; 3) creating 1-page survey addressing NCCN recommended topics to pre-screen for concerns discussed at SCP visit and using a visit template to track topics covered plus information and referrals provided, 4) establishing processes and delivery dates for SCP & visit to newly diagnosed patients and 5) developing algorithms for referral for SCP & visit (4-8 weeks from EOT) including adding “SCP visits” to EHR-chemotherapy plans and other auto-reminders. Clinic-wide implementation began 7/2015; updated results will include: EHR-tracked, provision rate, type and frequency of survivor concerns and referral patterns and time for SCP creation and visits. Survivor/clinician satisfaction with EHR-based program will also be included. Conclusions: EHR-based SCP creation, provision and tracking is feasible. Future plans include assessing time and personnel resources required, and comparing the accuracy of EHR-tracking with cancer registry data or other standards used to address guideline compliance.

HospitalizationsThe risk of rehospitalization in the TG was 40% lower (P 5.03) than in the CG. The ratio of the risk of rehospitalization, after the Di.Pro.Di and before, was 0.30 (P 5.009). Length of StayThe duration of hospital stay was 10.4 days shorter in the TG (Po.001) than in the CG. The duration of hospital stay was in the TG was 11.9 days shorter after the Di.Pro.Di than before (Po.001). CONCLUSIONDi.Pro.Di significantly reduced number of rehospitalizations and hospital length of stay. A possible reason is that Di.Pro.Di allows patients to be fully stabilized before complete discharge. As in other DMPs, Di.Pro.Di improved the education of patients and families, improving adherence to therapy and lifestyle after discharge. These preliminary results suggest that Di.Pro.Di improves the effectiveness of care for elderly patients with CHF.

The purpose of the study was to evaluate the relationship between catastrophism and somatosensory, emotional and cognitive dimensions of pain in patients with advanced cancer. Seventy patients (22M,48F) of mean age 52.7 years with advanced cancer, stage II-IV, participated in the study. Karnofsky Performance Status ranged between 90 and 60, ean pain intensity was 2.2, SD 1.7 (range 0-5). Duration of cancer ranged between 2 and 240 months. 37% of patients had breast cancer, 1.8% prostate, 3.6% head or neck, 10.7% lung/bronchus, 17.9% colorectal, 28.6% other. Catastrophizing related to pain (CAT) was assessed with the Pain Coping Strategy Questionnaire (CSQ), and somatosensory, emotional and cognitive dimensions of pain were evaluated using the Multidimensional Affect and Pain Survey (MAPS). MAPS contains 101 pain and emotion descriptors grouped into 30 clusters and 3 Superclusters (SC): I. Somatosensory Pain SC, II. Emotional Pain SC, and III. Wellbeing SC. Descriptive statistics, t-test for independent samples, and Pearson correlations were used to evaluate the data. No gender differences were found, and patients' performance status did not correlate with CAT. CAT correlated highly with 5 of 8 clusters within the MAPS Emotional Pain SC: Fear (r ϭ 0.38, pϭ0.001), Anxiety (r.ϭ 0.35, pϭ0.003), Fatique (r ϭ 0.35, pϭ0.004), Anger (r.ϭ 033, pϭ0.005) and Response to Illness (ailing/suffering) (r ϭ 0.32, pϭ0.007), and with 6 of 17 clusters of the MAPS Somatosensory Pain SC: Cutaneous Sensation (r ϭ 0.34, pϭ0.004), Sensory Distress (r ϭ0.33,pϭ0.006), Intermittent Pressure (r ϭ 0.32, pϭ0.006), Incisive Pressure (r ϭ 0.37, pϭ0.002), Traction/Abrasion (r ϭ 0.33, pϭ0.006) and Intense pain (r ϭ0.32, pϭ0.007). Surprisingly, CAT did not correlate significantly with any cluster within the MAPS Well-being SC. Catastrophizing about pain in cancer patients is related to negative feelings such as fear, anxiety and anger, and to somatosensory characteristics of pain.