UCSF

The Experience of Cancer Pain and Barriers to Cancer Pain Management in a Community Sample of Chinese American Cancer Patients

Janet Edrington

Abstract

Approximately 3 million Chinese Americans live in the United States. While cancer rates are lower in the Asian population compared to the white, non-Hispanic population, certain cancer rates (i.e., liver, lung, stomach) are higher in the Chinese population. Pain is a common and persistent problem in cancer patients. However, to date no studies have evaluated the experience of cancer pain in Chinese American patients. McGuire's Multidimensional Model of cancer pain (e.g., physiologic, sensory, affective, cognitive) served as the theoretical framework for this study.

Purposes of this dissertation research, in a community sample of Chinese American patients with cancer pain, were: to describe the experience of cancer pain; to examine patient barriers to cancer pain management; and to describe the relationships between various aspects of the pain experience and patient barriers to their acculturation level.

This descriptive correlational study recruited a convenience sample of patients from three community settings in Northern California. Patients completed six self-report questionnaires on their pain severity, pain interference with function, barriers to pain management, mood disturbances, acculturation levels, and pain treatments.

Patients reported moderate to severe levels of worst pain; that pain interfered with many of their activities of daily living; as well as moderate levels of depression and anxiety. Barriers to cancer pain management reported most frequently included: concerns about tolerance, dosage of pain medication, disease progression, and addiction. Patients with higher levels of depression, more years of education, inadequate analgesic prescription, and stronger Asian identification reported significantly higher barrier scores. A stronger Asian identification was associated with higher least and worst pain intensity scores, with higher pain interference scores, and with higher barrier subscales scores for tolerance and dosage concerns. Finally, 60% of the patients were receiving inadequate treatments for their cancer pain.

Cancer pain was found to be inadequately treated in Chinese American cancer patients. Better assessment of pain is needed for Chinese American cancer patients. Health care providers need to assess patients' concerns about pain management and the treatments they use for their pain.