Original Articles
Culture, pain, and culturally sensitive pain care,☆☆

https://doi.org/10.1053/jpmn.2000.9761Get rights and content

Abstract

One of the factors that can influence a person's perception of the pain experience is culture. With the large increase in the immigrant population in the United States, particularly immigrants coming from nontraditional regions such as Southeast Asia and Latin America, clinicians need to develop increased sensitivity to the influence of culture on health care beliefs and practices. To more effectively manage pain, clinicians need to conduct culturally sensitive pain assessments that elicit information concerning patients' and family members' beliefs about the pain experience. In addition, the patient's and family members' cultural beliefs and approaches toward traditional healing practices need to be incorporated into the pain management plan. © 2000 by the American Society of Pain Management Nurses

Section snippets

Culturally oriented pain education

Unlike most other early cancer pain education initiatives, the Boston Cancer Pain Education Program (BCPEP) stressed cultural diversity and minority status. In addition, the BCPEP aimed its educational efforts at both nurses, patients, and their family members. Funded by the National Cancer Institute, we educated over 500 nurses spanning the care continuum of home, hospital, and hospice, who in their daily work encountered patients from a broad range of cultures other than their own. At

Culturally relevant barriers to pain control

Culture has a vital influence on illness beliefs and behaviors, health care practices, help-seeking activities, and receptivity to medical care interventions (Good, Brodwin, Good, & Kleinman, 1992; Harwood, 1981; Kleinman, 1980; Leininger, 1991; Meinhart & McCaffrey, 1983; Spector, 1991; Varrichio, 1987). Western-trained clinicians view the medical care system as technologically sophisticated and helpful in the curing process. However, patients may fear hospitals as places to die and may

The importance of a cultural assessment

A variety of differences exist both between and within cultural groups (Harwood, 1981; Kleinman, 1980; Lee & Fong, 1990; Meinhart & McCaffrey, 1983; Rowell, 1990). Because of diversity both between and within cultures, it is important for the clinician not to make stereotypic judgments based on a person's ethnic heritage but to conduct a cultural assessment of the patient. Clinicians need to pay attention to inter- and intracultural differences. Table 1 provides a tool that nurses can use to

Research on culture and pain

Early research on the relationship of culture and pain, conducted by 2 sociologists (Zborowski, 1960; Zola, 1963), found that reactions to pain varied by cultural group and reflected the beliefs of the group. More recently, epidemiologists, clinical epidemiologists, psychologists, nurses, physicians, and anthropologists are among the disciplines that have sought to explain how culture is related to pain. Laboratory studies (Garron & Leavitt, 1979; Lipton & Marbach, 1984) tend to report that

Cultural sensitivity in the clinical encounter

Cultural coding and encoding within the context of a clinician and patient interaction is not a one-way street. Not only do the patient and family members bring their own distinctive cultural background, but clinicians have their own personal cultural background as well as the overriding culture provided by their training in western biomedicine. The “culture” of a hospital, hospice, or home health care agency must not be overlooked because it influences how well an institution works and how

Providing culturally sensitive pain care

In approaching any patient in pain, the first rule is to avoid cultural stereotyping and to be open, authentic, sensitive, and caring. Culture is, above all, an involving process. The more that is learned about the cultural features of a particular patient population, the better equipped the clinician will be to work effectively with patients in pain. However, it is not just a matter of formal training. Clinicians need to read books and articles about various cultural groups within their

The role for the American Society of Pain Management Nurses

Nurses are considered the cornerstone of good pain management because they often know the patient better than the rest of the health care team. The American Medical Association recently established a new website featuring nearly 500 pages devoted to cultural diversity and competency. Some, but not much, of this material has come from nurses and other allied health professionals. Yet, nurses have made substantial contributions to cultural sensitivity and because of their close relationship with

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    Supported by grants from the National Cancer Institute (CA 60343 and CA 65055).

    ☆☆

    Address correspondence and reprint requests to Kathryn Lasch, PhD, MA, MSSW, The Health Institute, New England Medical Center, 750 Washington St, Box 345, Boston, MA 02111.

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