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Community health center patient perspectives on their chronic pain

Gonzalo Bacigalupe, EdD, Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, 6172877631, gonzalo.bacigalupe@umb.edu and Carole Upshur, EdD, Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Ave. North, Worcester, MA 01655.

Chronic or persistent pain is one of the most common complaints of patients in primary care. Estimates of prevalence in the general population range from 14-46.5%. Despite a growing body of multidisciplinary pain research, few studies have addressed the basic contextual challenges of providing primary care for chronic pain among diverse and disadvantaged populations. At the same time, there is evidence that physicians assess and treat pain differently in minorities. In addition, while active patient self-management premised on a good patient-physician relationship is key to treatment of chronic conditions, minority patients and those with less education have been found to view patient-centered care as less valuable. A team of researchers explored these issues through patient focus groups in three community health centers in Central Massachusetts. Patients with chronic pain were recruited through letters and flyers distributed at primary care clinics. The interviewers asked participants how they felt their health care provider and the center treated them; what aspects of their treatment were successful; and what aspects of their treatment were not successful. Patients reported significant dissatisfaction with the way support staff at health centers interacted with them. They felt frequently accused of drug seeking behavior, at the same time feeling that inadequate medication was provided. Patients also expressed a need for alternative approaches than medication that should be provided at the health center. The burden of not being able to work and of accompanying depression were emphasized as significant negative consequences of unresolved pain.

Learning Objectives: At the completion of the session, participants will be able to

Keywords: Minority Health, Chronic Illness

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Confronting Myths and Fears of Cancer in the Minority Belief Systems

The 132nd Annual Meeting (November 6-10, 2004) of APHA