title: Meta-analysis of cultural differences in Western and Asian patient-perceived barriers to managing cancer pain.
abstract: OBJECTIVE
  barriers to managing cancer pain contribute to cancer patients' reluctance to report pain and use prescribed analgesics, resulting in inadequate pain control. Patients' perceived barriers to managing cancer pain may be influenced by culture. This meta-analysis compared differences in Western and Asian patient-perceived barriers to managing cancer pain.
  
  
  METHODS
  the literature was systematically reviewed to compare pain barriers in Western and Asian cancer patients in 22 studies that used Ward's Barrier Questionnaire. Differences in weighted barrier scores were compared by meta-regression analysis.
  
  
  RESULTS
  Asian cancer patients had higher barrier scores than Western patients, except for barriers of 'good patient', 'side effects', 'distract physician', 'fear of injections', and 'addiction'. Meta-regression analysis indicated that Asian patients' perceived pain barriers differed significantly from those of Western patients for disease progression (weighted mean difference [WMD] = 1.32; 95% confidence interval [CI] 0.80, 1.84, p < 0.0001), tolerance (WMD = 1.63; 95% CI 0.91, 2.36, p < 0.0001), fatalism (WMD = 0.89; 95% CI 0.28, 1.52, p = 0.004), and total score (WMD = 0.82; 95% CI 0.36, 1.28, p < 0.0001).
  
  
  CONCLUSIONS
  Asian patients' perceived barriers to managing cancer pain were significantly higher than those for Western patients (especially for concerns about disease progression, tolerance, and fatalism). Asian cancer patients need to be assessed and carefully treated for perceived barriers to optimize cancer pain management.
authors.affiliation: Chang Gung University, Graduate School of Nursing, Tao-Yuan, Taiwan, ROC.
authors.forename: Chen Hsiu
authors.initials: CH
authors.lastname: Chen
authors.forename: Siew Tzuh
authors.initials: ST
authors.lastname: Tang
authors.forename: Chien Hao
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D003144:Communication Barriers; D003431:Cross-Cultural Comparison; D003657:Decision Making / Q000941:ethics; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D059408:Pain Management / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology*; D011379:Prognosis
chemical_list: D000700:Analgesics