title: Arthritis beliefs and self-care in an urban American Indian population.
abstract: OBJECTIVE
  To describe beliefs and self-care strategies of American Indians with chronic arthritis joint pain.
  
  
  METHODS
  In-depth interviews were conducted with a convenience sample of urban-dwelling American Indians (n = 56) concerning self-care and beliefs about arthritis; objective measures of arthritis disease activity were obtained through standardized interview protocols.
  
  
  RESULTS
  Joint pain was not generally assumed to be arthritis nor directly related to aging. Belief that chronic pain affecting multiple joints was a serious and unexpected condition oriented American Indians' decisions to seek medical attention. However, verbal communications about pain may be subtle or under emphasized. Few coping strategies were used to control either chronic or episodic pain.
  
  
  CONCLUSIONS
  Chronic arthritis pain may not be optimally managed in this population. Cultural assessment should recognize that American Indian patients may understate serious symptoms. Community educational interventions should target this population to enhance self-care, pain management, and communication of arthritis symptoms to physicians.
authors.affiliation: Department of Veterans Affairs Greater Los Angeles Healthcare System, Geriatric Research Education Clinical Center, Sepulveda, California, USA. Josea.Kramer@med.va.gov
authors.forename: B Josea
authors.initials: BJ
authors.lastname: Kramer
authors.forename: Judith O
authors.initials: JO
authors.lastname: Harker
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Wong
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000208:ethnology* / Q000523:psychology*; D001294:Attitude to Health; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D012648:Self Care; D014505:Urban Population