As a primarily subjective phenomenon, pain expression may vary among different populations. Patients from minority populations may be more likely to have poor pain management, less analgesia prescribed, and lower doses administered for their pain. To understand better the Hispanic pain experience, qualitative methods were used to gather data from postoperative adult Hispanic patients in both an urban and rural setting regarding their perspective and response to the pain experience. Descriptive qualitative analysis of interview data from a sample (n=35) of predominantly female, married and Catholic respondents, ranging in age from 23-80 years yielded five categories: Characteristics of the pain experience; Managing pain; Information about pain; Interactions with providers, and Cultural considerations. Several themes defined each category and were used in a larger study to develop a Spanish language instrument to measure pain outcomes.
Descriptions of the categories and themes and implications for further research and clinical care are presented. For Hispanic populations, cultural issues having an impact on research regarding pain, such as simpatia (a striving for harmonious relationships without interpersonal conflict), respect, and family involvement, as well as problems with recruitment of minority patients to research studies, must be addressed to improve the effectiveness of pain management for this group.
American Pain Society (APS) Quality of Care Committee (1995) Quality improvement guidelines for the treatment of acute pain and cancer pain . Journal of the American Medical Association274: 23, 1874-1880 .
2.
Anderson, K. O. , Mendoza, T. R. , Valero, V.et al. (2000) Minority cancer patients and their providers . Cancer88: 8, 1929-1938 .
3.
Bates, M. (1987) Ethnicity and pain: A biocultural model . Social Science in Medicine24: 47-50 .
4.
Bonham, V. (2001) Race, ethnicity and pain treatment: Striving to understand the causes and solutions to the disparities in pain treatment . Journal of Law, Medicine and Ethics29: 52-68 .
5.
Brislin, R.W. , Lonner, W. J. , Thorndike, R. M. (1973) Cross-cultural Research Methods. New York: John Wiley and Sons .
6.
Calvillo, E. R. , Flaskerud, J. H. (1993) Evaluation of the pain response by Mexican-American and Anglo-American women and their nurses . Journal of Advanced Nursing18: 3, 451-459 .
7.
Carr, E. C. J. , Mann, E. M. (2000) Pain. London: MacMillan Press Ltd.
8.
Cleeland, C. , Gonin, R. , Hatfield, A.et al. (1994) Pain and its treatment in outpatients with metastatic cancer . New England. Journal of Medicine330: 9, 595-596 .
9.
Ebener, M. K. (1997) Caring for persons in pain: Constructing the experience . International Journal of Human Caring1: 2, 40-45 .
10.
Gordon, C. (1997) The effect of cancer pain on quality of life in different ethnic groups: A literature review . Nurse Practitioner Forum3: 1, 5-13 .
11.
Juarez, G. , Ferrell, B. , Borneman, T. (1998) Influence of culture on cancer pain management in Hispanic patients . Cancer Practice6: 5, 262 .
12.
Lee, W. W. , Burelbach, A. E. , Fornocht, D. (2001) Hispanic and non-Hispanic White patient pain management expectations . American Journal of Emergency Medicine19: 7 . Accessed January 30, 2002 from: http://home.medconsult.com/das/arti...68907&sid=82039923/N?252234/1/html
13.
Low, J. F. (1997) Religious orientation and pain management . The American Journal of Occupational Therapy51: 3, 215-219 .
14.
Marin, B.V.O. , Marin, G. (1991). Research with Hispanic Populations. Newbury Park: Sage Publications .
15.
McNeill, J. , Sherwood, G. , Palos, G.et al. (2003) Design strategies in pain management research with Hispanics . Hispanic Health Care International. In press.
16.
McNeill, J.A. , Sherwood, G. D. , Starck, P. L. (2001) Pain management outcomes for hospitalised Hispanic patients . Pain Management Nursing2: 1, 25-36 .
17.
McNeill, J. A. , Sherwood, G. D. , Starck, P. L.et al. (1998) Assessing clinical outcomes: Patient satisfaction with pain management . Journal of Pain and Symptom Management16: 1, 29-40 .
18.
Morse, J. (1994) Emerging from the data: The cognitive process of analysis in qualitative inquiry. In: Morse, J. (ed). Critical Issues in Qualitative Research Methods. Newbury Park, CA: Sage , 23-43.
19.
Ng, B. , Dimsdale, J. , Schragg, G. P.et al. (1996) Ethnic differences in analgesic consumption for postoperative pain . Psychosomatic Medicine58: 125-129 .
20.
Rich, B. A. (2000) An ethical analysis of the barriers to effective pain management . Cambridge Quarterly of Healthcare Ethics9: 54-70 .
21.
Sherwood, G. , Adams-McNeill, J. , Starck, P. L.et al. (2000) Qualitative assessment of hospitalized patients' satisfaction with pain management . Research in Nursing and Health23: 486-495 .
22.
Starck, P. L. , Sherwood, G. D. , Adams-McNeill, J.et al. (2001) Identifying and addressing medical errors in pain mismanagement . Journal of Qualitylmprovement27: 4, 191-199 .
23.
Todd, K. H. , Samaroo, N. , Hoffman, J. R. (1993) Ethnicity as a risk factor for inadequate emergency department analgesia . Journal of the American Medical Association269: 1537-1539 .
24.
Todd, K. H. (1996) Pain assessment and ethnicity . Annals of Emergency Medicine27: 421-432 .
25.
Vilaro, F. M. (1994) Methodological issues in the implementation of research in a Latino population. Nursing research and under-served populations . Third National Conference on Cancer Nursing Research. Newport Beach, California: American Cancer Society, Inc.
26.
Ward, S. , Hernandez, L. (1994) Patient-related barriers to management of cancer pain in Puerto Rico . Pain58: 233-238 .
27.
Zoucha, R. , Reeves, J. (1999) A view of professional caring as personal for Mexican Americans . International Journal for Human Caring; Fall, 14-20 ,
