FAST FACT AND CONCEPT #78: Cultural Aspects of Pain Management

2nd Edition

Deb Gordon RN and Shiva Bidar-Sielaff

Culture is the framework that directs human behavior in a given situation. The meaning and expression of pain are influenced by people’s cultural background. Pain is not just a physiologic response to tissue damage but also includes emotional and behavioral responses based on an individuals’ past experiences and perceptions of pain. Not everyone in every culture conforms to a set of expected behaviors or beliefs, so cultural stereotyping (assuming a person will be stoic or very expressive about pain) can lead to inadequate assessment and treatment of pain. Many studies have shown that patients from minority groups and cultures different from that of health care professionals treating them receive inadequate pain management.

Health care professionals need to be aware of their own values and perceptions as they affect how they evaluate the patient’s response to pain and ultimately how pain is treated. Even subtle cultural and individual differences, particularly in nonverbal, spoken, and written language between health care providers and patients impact care.

To be culturally competent, you must:

You must Listen with empathy to the patient’s perception of their pain, Explain your perception of the pain problem, Acknowledge the differences and similarities in perceptions, Recommend treatment, and Negotiate agreement.

Questions that staff can use to help assess cultural differences in order to better assess and work out an appropriate pain management plan with a patient and family include:

This Fast Facts was adapted with permission from: Pain Management Fast Facts - 5 Minute Inservice, University of Wisconsin Hospital and Clinics, Madison, WI

References

  1. Anderson KO et al. Pain education for underserved minority cancer patients: a randomized controlled trial. Journal of Clinical Oncology 2004;22(24):4918-4925.
  2. Davidhizar R, Giger JN. A review of the literature on care of clients in pain who are culturally diverse. International Nursing Review 2004;51(1):47-55.
  3. Bates M.S., Rankin-Hill, L., & Sanchez-Ayendez, M. (1997) The Effects of the Cultural Context of Health Care on Treatment of and Response to Chronic Pain and Illness. Social Science and Medicine, 45(9). 1433-1447.

Fast Facts were edited by David Weissman MD, Palliative Care Center, Medical College of Wisconsin until January 2007.  For comments/questions write to the current editor, Drew Rosielle MD: drosiell@mcw.edu. The complete set of Fast Facts is available at EPERC: www.eperc.mcw.edu

Copyright/Referencing Information: Users are free to download and distribute Fast Facts for educational purposes only. Citation for referencing: Gordon D, and Bidar-Sielaff S. Fast Facts and Concepts #78 Cultural aspects of pain management, 2nd Edition. July 2006. End-of-Life / Palliative Education Resource Center: http://www.eperc.mcw.edu.

Disclaimer: Fast Facts provide educational information. This information is not medical advice. Health care providers should exercise their own independent clinical judgment. Some Fast Fact information cites the use of a product in dosage, for an indication, or in a manner other than that recommended in the product labeling. Accordingly, the official prescribing information should be consulted before any such product is used.

Creation Date: 10/2002

Purpose: Instructional Aid, Self-Study Guide, Teaching

Audience(s)

    

Training: Fellows, 1st/2nd Year Medical Students, 3rd/4th Year Medical Students, PGY1 (Interns), PGY2-6, Physicians in Practice

    

Specialty: Anesthesiology, Emergency Medicine, Family Medicine, General Internal Medicine, Geriatrics, Hematology/Oncology, Neurology, OB/GYN, Ophthalmology, Pulmonary/Critical Care, Pediatrics, Psychiatry, Surgery

    

Non-Physician: Clergy/Chaplains, General Public, Graduate Students, Lawyers, Patients/Families, Nurses, Social Workers

ACGME Competencies: Interpersonal and Communication Skills, Patient Care

Keyword(s): Pain>evaluation; communication