Original Article
Barriers to Pain Management in a Community Sample of Chinese American Patients with Cancer

https://doi.org/10.1016/j.jpainsymman.2008.04.014Get rights and content
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Abstract

Barriers to cancer pain management can contribute to the undertreatment of cancer pain. No studies have documented barriers to cancer pain management in Chinese American patients. The purposes of this study in a community sample of Chinese Americans were to: describe their perceived barriers to cancer pain management; examine the relationships between these barriers and patients' ratings of pain intensity, pain interference with function, mood disturbances, education, and acculturation level; and determine which factors predicted barriers to cancer pain management. Fifty Chinese Americans with cancer pain completed the following instruments: Brief Pain Inventory (BPI), Karnofsky Performance Status (KPS) Scale, Barriers Questionnaire (BQ), Hospital Anxiety and Depression Scale (HADS), Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA), and a demographic questionnaire. The mean total BQ score was in the moderate range. The individual barriers with the highest scores were: tolerance to pain medicine; time intervals used for dosage of pain medicine; disease progression; and addiction. Significant correlations were found between the tolerance subscale and least pain (r = 0.380) and the religious fatalism subscale and average pain (r = 0.282). These two subscales were positively correlated with anxiety and depression levels: (tolerance: r = 0.282, r = 0.284, respectively; religious fatalism: r = 0.358, r = 0.353, respectively). The tolerance subscale was positively correlated with pain interference (r = 0.374). Approximately 21% of the variance in the total BQ score was explained by patients' education level, acculturation score, level of depression, and adequacy of pain treatment. Chinese American cancer patients need to be assessed for pain and perceived barriers to cancer pain management to optimize pain management.

Key Words

Barriers
cancer pain
Chinese
acculturation
ethnicity

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Dr. Edrington's work was partially supported by a T32 Nursing Research Training in Symptom Management Scholarship from the National Institutes of Health and the National Institute of Nursing Research NR00788-07. Ms. Sun's work was partially supported by a grant from the National Cancer Institute (U01CA114640 from the Center to Reduce Cancer Health Disparities/NCI, and the Asian American Network for Cancer Awareness, Research and Training). Dr. Miaskowski's work was partially supported by grants from the National Cancer Institute and the National Institute of Nursing Research.