University of New Mexico College of Nursing, Albuquerque, New Mexico, USA.
J Pain Symptom Manage. 2013 Jun;45(6):1050-60. doi: 10.1016/j.jpainsymman.2012.06.001. Epub 2012 Aug 31.
Although minority patients with cancer are more likely to be undermedicated for cancer pain than non-Hispanic whites, little is known about the experience of cancer pain in American Indians (AIs).
To describe the experience of cancer and cancer pain in a sample of southwestern AIs.
Ethnographic interviews were conducted with 13 patients and 11 health care providers, caregivers, and community members; two questionnaires were used to collect demographic and pain data.
Barriers to pain control among AIs included difficulties describing pain, a belief that cancer pain is inevitable and untreatable, and an aversion to taking opioid pain medication. Prescriber inexperience also was cited as a barrier to pain management. AIs described a strong desire to protect their privacy regarding their illness, and many felt that expressing pain was a sign of weakness. The inability to participate in spiritual and cultural activities caused AIs distress, and some discontinued treatment or missed chemotherapy appointments to engage in these activities.
Results revealed new knowledge about the cancer pain experience in AIs. The observation of the close relationship between treatment compliance and the patient's ability to participate in ceremonial and spiritual activities provides new insight into the problem of incomplete cancer treatment in this population. The finding that AI patients have a multidimensional conceptualization of pain will assist clinicians with obtaining more detailed and informative pain assessments.
尽管癌症少数民族患者比非西班牙裔白人患者更有可能接受不足的癌症疼痛治疗，但对于美国印第安人（AI）的癌症疼痛体验知之甚少。
描述西南地区 AI 癌症患者的癌症和癌症疼痛体验。
对 13 名患者和 11 名医疗保健提供者、护理人员和社区成员进行了人种学访谈；使用了两份问卷来收集人口统计学和疼痛数据。
AI 患者控制疼痛的障碍包括难以描述疼痛、认为癌症疼痛是不可避免且无法治疗的信念、以及对服用阿片类止痛药的反感。处方者缺乏经验也被认为是疼痛管理的障碍。AI 患者强烈希望保护他们的隐私，许多人认为表达疼痛是软弱的表现。无法参加精神和文化活动会给 AI 患者带来痛苦，一些人会因此停止治疗或错过化疗预约，以参与这些活动。
结果揭示了 AI 癌症疼痛体验的新知识。观察到治疗依从性与患者参与仪式和精神活动的能力之间的密切关系，为这一人群中癌症治疗不完全的问题提供了新的见解。发现 AI 患者对疼痛有一个多维的概念化，将有助于临床医生进行更详细和信息丰富的疼痛评估。
