261426 We don't talk about it: Cancer pain and American Indian survivors

Sunday, October 28, 2012

Felicia Schanche Hodge, DrPH , School of Nursing, University of California, Los Angeles, Los Angeles, CA
Mary Cadogan, DrPH, APRN, BC , School of Nursing, University of California, Los Angeles, Los Angeles, CA
Tracy Line Itty, MPH , School of Nursing, University of California, Los Angeles, Los Angeles, CA
Fernando Martinez , School of Nursing, University of California, Los Angeles, Los Angeles, CA
Communication is an important part of the cancer experience. This paper reports on qualitative findings of a study looking at the pain experience of American Indian cancer patients and survivors, particularly in the areas of communication with family and healthcare providers. Analysis based on Grounded Theory techniques was used to assess the communication patterns of American Indian cancer patients/survivors residing in the Southwest. Twenty individual interviews and 13 focus groups examined key themes in cancer pain communication. The results were categorized into communication with nuclear/extended family members and communication with healthcare providers. Within these two categories, three themes emerged: (1) “we don't talk about it” (expectations not to burden others); (2) respect for healthcare providers (correcting or asking questions of providers is shameful); and (3) cancer experience is “meant to be” (fate cannot be altered). Cultural factors, such as perceptions of fatalism and respect for others, greatly influence the communication patterns of American Indian patients/survivors, resulting in the minimizing of reports and complaints regarding cancer pain. Understanding communication patterns and the reasons for reduced communication reported by cancer patients/survivors is important for healthcare providers, caregivers and others providing treatment and control of cancer pain.

Learning Areas:
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related research

Learning Objectives:
1. Identify three themes influencing communication about cancer pain among American Indians 2. Analyze pain-related communication patterns of American Indian patients and survivors.

Keywords: American Indians, Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of multiple federally funded grants focusing on American Indian health care needs, and have extensive experience in cancer prevention and 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.