Cancer pain management among underserved minority outpatients: perceived needs and barriers to optimal control.
BACKGROUND
Minority patients with cancer are at risk for undertreatment of cancer-related pain. Most studies of patient-related barriers to pain control have surveyed primarily non-Hispanic Caucasian patients. The purpose of the current study was to explore barriers to optimal pain management among African-American and Hispanic patients with cancer through the use of structured patient interviews. Structured interviews allowed the authors to probe for previously unidentified barriers to pain management in these populations.


METHODS
Thirty-one socioeconomically disadvantaged minority patients with cancer (14 African-American patients and 17 Hispanic patients) who had cancer-related pain completed structured interviews that assessed three main content areas: information and communication regarding cancer pain, treatment of cancer pain, and the meaning of cancer pain.


RESULTS
The African-American and Hispanic patients reported severe pain and many concerns about pain management. The majority of patients in both ethnic groups expressed a belief in stoicism and concerns about possible addiction to opioid medications and the development of tolerance. The patients described their physicians as the most frequent and trusted source of information about cancer pain. However, patients also reported difficulties with communication and a reluctance to complain of pain.


CONCLUSIONS
The reported barriers to pain management indicate that socioeconomically disadvantaged African-American and Hispanic patients can benefit from educational interventions on cancer pain that dispel myths about opioids and teach patients to communicate assertively about their pain with their physicians and nurses.
Anderson
Karen O
KO
Department of Symptom Research, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. koanderso@mdanderson.org
Richman
Stephen P
SP
Hurley
Judith
J
Palos
Guadalupe
G
Valero
Vicente
V
Mendoza
Tito R
TR
Gning
Ibrahima
I
Cleeland
Charles S
CS
D001741:Black or African American; D001291:Attitude of Health Personnel; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000503:physiopathology*; D010147:Pain Measurement; D010148:Intractable Pain / Q000208:ethnology* / Q000209:etiology / Q000628:therapy*