Testing Mediation in Nursing Research

“…The joint significance approach to mediation is the best of the all the causal steps approaches because it has more statistical power and the lowest Type I error rate (Krause et al, 2010). Table 3 lists the variables tested in the model.…”

Section: Discussionmentioning

confidence: 99%

Racial disparities in pain management in primary care

Ezenwa

Fleming

2012

The Journal of Pain

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This descriptive, cross-sectional, secondary data analysis was conducted to examine racial disparities in pain management of primary care patients with chronic nonmalignant pain using chronic opioid therapy. Data from 891 patients, including 201 African Americans and 691 Caucasians were used to test an explanatory model for these disparities. We predicted that: (1) African American patients would report worse pain management and poor quality of life (QOL) than Caucasians; (2) the association between race and pain management would be mediated by perceived discrimination relating to hopelessness; and (3) poor pain management would negatively affect QOL. Results revealed significant differences between African Americans and Caucasians on pain management and QOL, with African Americans faring worse. The proposed mediational model, which included race, perceived discrimination, hopelessness, and pain management was supported: (1) African Americans compared to Caucasians had higher perceived discrimination, (2) perceived discrimination was positively associated with hopelessness, and (3) higher hopelessness was associated with worse pain management. Further, pain management predicted QOL. This is the first study in which an explanatory model for the racial disparities in pain management of primary care patients with chronic nonmalignant pain was examined. Perceived discrimination and hopelessness were implicated as explanatory factors for the disparities.

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“…One statistical limitation with these studies is that researchers have not tested whether ABM has an indirect effect on behaviour via changes in AB, which is possible even in the absence of a direct effect of ABM on behaviour (see Krause et al, 2010). However, we conducted these analyses on datasets from three single-session ABM studies conducted in our laboratory (Field et al, 2007;Field, Duka, Tyler, & Schoenmakers, 2009;Field & Eastwood, 2005) and did not observe any statistically significant indirect effects (details available on request).…”

Section: The Causal Role Of Attentional Bias: Attentional Bias Modifimentioning

confidence: 90%

Less than meets the eye: Reappraising the clinical relevance of attentional bias in addiction

Christiansen

Schoenmakers

Field

2015

Addictive Behaviors

180

151

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Recent years have seen an explosion of interest in attentional bias in addiction, particularly its clinical relevance. Specifically, numerous articles claimed to demonstrate either that (1) attentional bias measured in treatment settings could predict subsequent relapse to substance use, or (2) direct modification of attentional bias reduced substance use and improved treatment outcomes. In this paper, we critically evaluate empirical studies that investigated these issues. We show that the evidence regarding both of these claims is decidedly mixed, and that many of the studies that appear to yield positive findings have serious methodological and statistical limitations. We contend that the available literature suggests that attentional bias for drug cues fluctuates within individuals because it is an output of the underlying motivational state at that moment in time, but there is no convincing evidence that it exerts a causal influence on substance use. Future research should make use of experience sampling methodology to characterise the clinical significance of fluctuations in attentional bias over time.

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Testing Mediation in Nursing Research

Cited by 69 publications

References 30 publications

Omega-3 index levels and associated factors in a middle-aged French population: the MONA LISA-NUT Study

Omega-3 index levels and associated factors in a middle-aged French population: the MONA LISA-NUT Study

Racial disparities in pain management in primary care

Less than meets the eye: Reappraising the clinical relevance of attentional bias in addiction

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