Laura Porter

Overview:

My research focuses on developing and evaluating behavioral interventions to help patients and their family members cope with the symptoms and psychological demands associated with chronic and life-limiting illness.

Positions:

Professor in Psychiatry and Behavioral Sciences

Psychiatry & Behavioral Sciences, Behavioral Medicine
School of Medicine

Professor in the School of Nursing

School of Nursing
School of Nursing

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 1996

State University of New York, Stony Brook

Grants:

Feasibility of a Couple-based Intervention for Parents of Children with Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Caregiver-Assisted Pain Coping Skills Training for Dementia

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Palliative Care Research Center
Role
Principal Investigator
Start Date
End Date

Yoga-based Symptom Management for Metastatic Breast Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Coping Skills Training for Spinal Cord Stimulator Patients

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Partner-Assisted Emotional Disclosure for GI Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Publications:

Efficacy of a multimedia intervention in facilitating breast cancer patients' clinical communication about sexual health: Results of a randomized controlled trial.

OBJECTIVE: Many women with breast cancer (BC) hesitate to raise sexual concerns clinically. We evaluated a multimedia intervention to facilitate BC patients' communication about sexual/menopausal health, called Starting the Conversation (STC). METHODS: Female BC patients (N = 144) were randomly assigned to either STC (20-min video, workbook, and resource guide) or control (resource guide only). Audio-recorded dialogue from patients' next oncology clinic encounter was coded for patients' sexual health communication. Self-report surveys assessed patients' beliefs about sexual health communication, self-efficacy for clinical interactions, sexual function/activity, anxiety/depression symptoms, and quality of life at baseline, post-intervention, and 2-month follow-up. T-tests or mixed-effects logistic regression compared study arms. RESULTS: Women in the STC arm were more likely to raise the topic of sexual health (51%; OR = 2.62 [1.02, 6.69], p = 0.04) and ask a sexual health question (40%; OR = 2.85 [1.27, 6.38], p = 0.01) during their clinic encounter than those in the control arm (30% and 19% for raise and ask, respectively). At follow-up, women in the STC arm showed greater improvements in sexual health communication self-efficacy (p = 0.009) and in anxiety symptoms (p = 0.03), and more women were sexually active at follow-up, compared to the control arm (OR = 1.5, 70% vs. 46%, p = 0.04). CONCLUSIONS: The STC intervention facilitated women's clinical communication about sexual health and reduced women's anxiety, possibly due to increased confidence in expressing their medical needs. Helpful information gained from clinical discussions could have improved women's willingness or ability to engage in sexual activity. Future studies should identify aspects of the clinical encounter most critical to improving women's sexual outcomes.
Authors
Reese, JB; Sorice, KA; Pollard, W; Handorf, E; Beach, MC; Daly, MB; Porter, LS; Tulsky, JA; Lepore, SJ
MLA Citation
Reese, Jennifer B., et al. “Efficacy of a multimedia intervention in facilitating breast cancer patients' clinical communication about sexual health: Results of a randomized controlled trial.Psychooncology, vol. 30, no. 5, May 2021, pp. 681–90. Pubmed, doi:10.1002/pon.5613.
URI
https://scholars.duke.edu/individual/pub1468823
PMID
33305520
Source
pubmed
Published In
Psychooncology
Volume
30
Published Date
Start Page
681
End Page
690
DOI
10.1002/pon.5613

Caregiver-guided pain coping skills training for patients with advanced cancer: Results from a randomized clinical trial.

BACKGROUND: Pain is a major concern among patients with advanced cancer and their family caregivers. Evidence suggests that pain coping skills training interventions can improve outcomes, however they have rarely been tested in this population. AIM: To test the efficacy of a caregiver-guided pain coping skills training intervention. The primary outcome was caregiver self-efficacy for helping the patient manage pain. DESIGN: A randomized controlled trial compared the intervention to an enhanced treatment-as-usual control. Dyads in both conditions received pain education, and those in the intervention received three sessions of pain coping skills training. Caregiver outcomes (self-efficacy; caregiver strain, caregiving satisfaction, psychological distress) and patient outcomes (self-efficacy, pain intensity and interference, psychological distress) were collected at baseline and post-intervention. SETTING/PARTICIPANTS: Two hundred two patients with stage III-IV cancer and pain and their family caregivers were enrolled from four outpatient oncology clinics and a free-standing hospice/palliative care organization. RESULTS: Compared to those in the control arm, caregivers in the intervention reported significant increases in caregiving satisfaction (p < 0.01) and decreased anxiety (p = 0.04). In both conditions, caregivers reported improvements in self-efficacy, and patients reported improvements in self-efficacy, pain severity and interference, and psychological distress. CONCLUSIONS: This is the first study to test a pain coping skills intervention targeted to patients and caregivers facing advanced cancer. Findings suggest that pain education provides benefits for patients and caregivers, and coping skills training may be beneficial for caregivers. Further research is needed to optimize the benefits of education and pain coping skills training for improving cancer pain outcomes.Trial registration: ClinicalTrials.gov NCT02430467, Caregiver-Guided Pain Management Training in Palliative Care.
Authors
Porter, LS; Steel, JL; Fairclough, DL; LeBlanc, TW; Bull, J; Hanson, LC; Fischer, S; Keefe, FJ
MLA Citation
Porter, Laura S., et al. “Caregiver-guided pain coping skills training for patients with advanced cancer: Results from a randomized clinical trial.Palliat Med, vol. 35, no. 5, May 2021, pp. 952–61. Pubmed, doi:10.1177/02692163211004216.
URI
https://scholars.duke.edu/individual/pub1477371
PMID
33775175
Source
pubmed
Published In
Palliat Med
Volume
35
Published Date
Start Page
952
End Page
961
DOI
10.1177/02692163211004216

Symptom experience and self-management for multiple co-occurring symptoms in patients with gastric cancer: A qualitative study.

PURPOSE: Patients with gastric cancer experience an increased symptom burden with multiple co-occurring symptoms. Knowledge of patients' symptom experiences and self-management for these symptoms is limited. The purpose of this study was to describe multiple co-occurring symptoms, symptom experiences, and symptom self-management strategies in patients with gastric cancer. METHODS: A qualitative descriptive approach was used for this study. Semi-structured interviews were conducted with ten American participants (median age 52.5 years, 50% female, 70% African American). Content analysis was used to explore their symptoms, experiences, and self-management strategies. RESULTS: Four themes were identified: perceptions of multiple co-occurring symptoms, complex and dynamic nature of symptom experiences, living with multiple co-occurring symptoms, and symptom self-management strategies (i.e., medications for symptoms, information seeking from the clinician team, lifestyle modification, psychosocial and spiritual support). CONCLUSIONS: Our findings provide new insights into how patients with gastric cancer perceive and interpret their multiple co-occurring symptoms, contribute to our understanding of the role that inter-individual variability might play in symptom experiences, and highlight a range of self-management strategies for managing multiple co-occurring symptoms. Oncology nurses need to assess symptoms on an ongoing basis, educate patients about multiple co-occurring symptoms, and develop and test person-centered self-management interventions for these patients to enhance their symptom relief and quality of life.
Authors
Lin, Y; Docherty, SL; Porter, LS; Bailey, DE
MLA Citation
Lin, Yufen, et al. “Symptom experience and self-management for multiple co-occurring symptoms in patients with gastric cancer: A qualitative study.Eur J Oncol Nurs, vol. 49, Dec. 2020, p. 101860. Pubmed, doi:10.1016/j.ejon.2020.101860.
URI
https://scholars.duke.edu/individual/pub1464055
PMID
33126154
Source
pubmed
Published In
Eur J Oncol Nurs
Volume
49
Published Date
Start Page
101860
DOI
10.1016/j.ejon.2020.101860

Changes in Identification of Possible Pain Coping Strategies by People with Osteoarthritis who Complete Web-based Pain Coping Skills Training.

BACKGROUND: We previously demonstrated that automated, Web-based pain coping skills training (PCST) can reduce osteoarthritis pain. The present secondary analyses examined whether this program also changed coping strategies participants identified for use in hypothetical pain-related situations. METHOD: People with hip/knee osteoarthritis (n = 107) were randomized to Web-based PCST or standard care control. At baseline and post-intervention, they reported their pain severity and impairment, then completed a task in which they described how they would cope with pain in four hypothetical pain-related situations, also reporting their perceived risk for pain and self-efficacy for managing it. We coded the generated coping strategies into counts of adaptive behavioral, maladaptive behavioral, adaptive cognitive, and discrete adaptive coping strategies (coping repertoire). RESULTS: Compared to the control arm, Web-based PCST decreased the number of maladaptive behavioral strategies generated (p = 0.002) while increasing the number of adaptive behavioral strategies generated (p = 0.006), likelihood of generating at least one adaptive cognitive strategy (p = 0.01), and the size of participants' coping repertoire (p = 0.009). Several of these changes were associated with changes in pain outcomes (ps = 0.01 to 0.65). Web-based PCST also reduced perceived risk for pain in the situations (p = 0.03) and increased self-efficacy for avoiding pain in similar situations (p < 0.001). CONCLUSION: Salutary changes found in this study appear to reflect intervention-concordant learning.
Authors
Rini, C; Katz, AWK; Nwadugbo, A; Porter, LS; Somers, TJ; Keefe, FJ
MLA Citation
Rini, Christine, et al. “Changes in Identification of Possible Pain Coping Strategies by People with Osteoarthritis who Complete Web-based Pain Coping Skills Training.Int J Behav Med, Nov. 2020. Pubmed, doi:10.1007/s12529-020-09938-w.
URI
https://scholars.duke.edu/individual/pub1464315
PMID
33174614
Source
pubmed
Published In
International Journal of Behavioral Medicine
Published Date
DOI
10.1007/s12529-020-09938-w

Yoga Practice Predicts Improvements in Day-to-Day Pain in Women With Metastatic Breast Cancer.

CONTEXT: Women with metastatic breast cancer (MBC) experience a significant symptom burden, including cancer pain. Yoga is a mind-body discipline that has shown promise for alleviating cancer pain, but few studies have included patients with metastatic disease or examined the acute effects of yoga practice. OBJECTIVES: To determine whether daily pain changed significantly during a randomized controlled trial of the Mindful Yoga program among women with MBC and whether time spent in yoga practice was related to daily pain. METHODS: On alternate weeks during the intervention period, we collected daily measures of pain from a subset of 48 women randomized to either yoga (n = 30) or a support group condition (n = 18). We also assessed daily duration of yoga practice among patients randomized to yoga. RESULTS: Pain levels were low for women in both conditions, and no differential treatment effects were found on daily pain. However, among women randomized to yoga, a dose/response relationship was found between yoga practice duration and daily pain. When patients had spent relatively more time practicing yoga across two consecutive days, they were more likely to experience lower pain on the next day. This finding is consistent with an earlier MBC study. Meditation practice showed the strongest association with lower daily pain. CONCLUSION: Findings suggest that yoga practice (meditation practice in particular) is associated with acute improvements in cancer pain, and that yoga interventions may be more impactful if tested in a sample of patients with advanced cancer in which pain is relatively elevated.
Authors
MLA Citation
Carson, James W., et al. “Yoga Practice Predicts Improvements in Day-to-Day Pain in Women With Metastatic Breast Cancer.J Pain Symptom Manage, Oct. 2020. Pubmed, doi:10.1016/j.jpainsymman.2020.10.009.
URI
https://scholars.duke.edu/individual/pub1463108
PMID
33065208
Source
pubmed
Published In
J Pain Symptom Manage
Published Date
DOI
10.1016/j.jpainsymman.2020.10.009