241017 Cancer Pain among Southwest American Indians

Tuesday, November 1, 2011: 8:30 AM

Mary Cadogan, DrPH, APRN, BC , School of Nursing, University of California, Los Angeles, Los Angeles, CA
Felicia Schanche Hodge, DrPH , School of Nursing, University of California, Los Angeles, Los Angeles, CA
Sally L. Maliski, RN, PhD , Nursing, UCLA, Los Angeles, CA
Tracy Line Itty, MPH , School of Nursing, University of California, Los Angeles, Los Angeles, CA
Across all cancer types, one of the most common and feared symptoms among individuals with cancer is pain. Although cancer is the second leading cause of mortality among American Indians (AI) over age 45, few studies have examined the cancer pain experience within this population. The purpose of this study was to describe from the perspectives of Southwest American Indians with cancer their experiences with cancer pain and barriers to effective pain management. Using Kleinmann's explanatory model to create a dialogue about cancer symptoms, face to face interviews were conducted with 17 Southwest American Indians with cancer. All interviews were audiotaped and transcribed verbatim. Analysis used grounded theory techniques to identify major categories in the data. Participants described pain in terms of common characteristics (intensity, location, timing) as well as in broader cultural terms. Pain was experienced prior to diagnosis, during treatment and some described persistent pain following treatment completion. Although reported pain burden was high among many respondents, themes related to stoicism and “not wanting to give in to pain” were evident. In addition to frequently described pain management barriers (side effects, fear of addiction) other unique situational barriers were described by participants. Financial concerns and self- perceived role expectations contributed to less than optimal pain relief among some participants. Self-management of pain incorporated broad strategies that addressed physical, psychosocial, cultural and spiritual aspects of pain.

Learning Areas:
Assessment of individual and community needs for health education
Diversity and culture
Planning of health education strategies, interventions, and programs

Learning Objectives:
1. Identify perceptions of pain described by Southwest American Indians with cancer. 2. Describe barriers to effective pain management faced by the American Indian population. 3. Discuss effective strategies to overcome pain management barriers.

Keywords: Native Americans, Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am a professor and the director of the Center for American Indian/Indigenous Research and Education (CAIIRE) and have overseen numerous research grants serving American Indians on a variety of health topics, including cancer symptom management.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.