Variations in Health IV
Purpose: To recognize and understand the effects of culture on pain perception, responses and management.
Choose an ethnic group to researc
Read the articles provided to you by your instructor.
Use this as a starting point for your discussion.
Describe the different natures of pain (physical, emotional, etc.)
2. Describe the relationship between ethnic background and pain.
3. Discuss ethnic differences in pain perception and pain responses
4. Explain how a nurse’s own culture, personal bias, values and beliefs may alter the interpretation of patients’ pain experience .
5. What might some variations be in assessment of pain when caring for the ethnic group you chose? What are the verbal cues? What are the non-verbal cues?
6. Which pain assessment tool would you use? Why?
7. What might some variations of nursing interventions be in management of pain when caring for the ethnic group you chose? Pharmaceutical: Traditional? Alternative? Interprofessional?
2. Discussed points 1 – 7 above
3. Strength of arguments
4. Minimumjof 4 references (including those provided)
5. Spelling and Grammar 1
6. APA format
15% 40% 20% 5% 10% 10%
Cultural Influences on the Experience of Pain
Pain is a complex, multifaceted experience that is shaped not only by biological factors but also by cultural and social contexts. While physical pain signals injury or illness, the way pain is perceived and expressed is learned through cultural norms and expectations (Hoffman et al., 2016). Research has demonstrated significant ethnic and cultural variations in how pain is understood, assessed, and managed. This article will explore some of the key differences in pain perception and responses among different ethnic groups and discuss implications for nursing care.
Perceptions of Pain
There are both physical and psychological components to pain. Physically, pain signals potential tissue damage through nociceptive pathways in the nervous system (Treede et al., 2015). However, the emotional experience of pain is mediated through higher cognitive and evaluative brain regions (Farmer et al., 2011). Cultural learning influences how physical pain sensations are interpreted and given meaning (Hoffman et al., 2016).
For example, research has found that Hispanic/Latinx individuals may be more likely to experience pain in psychosocial terms related to stress, sadness, or worry, rather than strictly as a physical sensation (Poleshuck & Green, 2008). In some Asian cultures, the experience of physical pain is seen as an inevitable part of life that should be endured quietly without complaint (Nahin, 2017). By contrast, in Western cultures pain is often viewed more as a physical problem that can and should be treated and resolved (Hoffman et al., 2016).
These differing cultural frameworks for understanding pain also influence how pain is expressed and responded to. Studies have shown that Hispanic/Latinx patients may be more likely to report high pain levels yet display few pain behaviors, while Asian Americans are more likely to underreport pain (Poleshuck & Green, 2008; Nahin, 2017).
African Americans have been found to display more outward expressions of pain such as grimacing or guarding movements compared to Caucasian Americans (Hoffman et al., 2016). Cultural stoicism norms may lead some ethnic groups like Asian Americans to endure pain privately without overt displays or verbal complaints (Nahin, 2017). However, failure to recognize these cultural differences could result in inadequate pain assessment and treatment (Hoffman et al., 2016).
When assessing pain in diverse populations, it is important for nurses to be aware of potential ethnic and cultural variations. Common pain scales used in clinical settings such as the numeric rating scale (NRS) or visual analog scale (VAS) may not adequately capture the pain experience of all ethnic groups (Hoffman et al., 2016). For example, these scales rely on self-reported pain scores, yet direct verbal reports of pain intensity may not align with actual pain levels for more stoic cultural groups (Nahin, 2017).
Additionally, pain behaviors observed during assessments may differ across ethnicities. For Hispanic/Latinx or African American patients, outward grimacing or guarding movements could indicate high pain levels, whereas for Asian American patients, lack of overt behaviors does not necessarily mean low pain (Poleshuck & Green, 2008; Hoffman et al., 2016). Using an interprofessional approach and incorporating family members familiar with the patient’s cultural norms into the assessment process can help provide a more comprehensive pain evaluation (Hoffman et al., 2016).
Managing pain also requires consideration of cultural beliefs and preferences regarding treatment approaches. For some ethnic groups, traditional or alternative remedies may be preferred over Western pharmaceutical options (Hoffman et al., 2016). Herbal medicines, acupuncture, massage, or spiritual/religious practices are common nonpharmacological approaches utilized in various Asian and Hispanic cultures (Nahin, 2017; Poleshuck & Green, 2008).
Involving interprofessional teams that include traditional healers or practitioners of alternative therapies can help ensure culturally congruent care (Hoffman et al., 2016). It is also important that nurses are sensitive to potential cultural taboos or concerns patients may have regarding certain treatments. For example, opioid analgesics that can cause sedation may not be acceptable for some Asian patients who believe pain should be endured alertly (Nahin, 2017). Considering such cultural values during pain management planning is essential.
In summary, significant ethnic and cultural variations exist in how pain is perceived, expressed, assessed, and treated. Nurses play a key role in providing culturally competent care by recognizing these differences and individualizing approaches. Using an interprofessional lens, incorporating family input, and respecting diverse cultural health beliefs can help ensure all patients receive effective pain relief in a manner congruent with their backgrounds and values. Failing to consider the cultural context of pain risks inadequate treatment and poor patient outcomes.
Farmer, M. A., Baliki, M. N., & Apkarian, A. V. (2011). A dynamic network perspective of chronic pain. Neuroscience letters, 520(2), 197–203. https://doi.org/10.1016/j.neulet.2012.05.001
Hoffman, K. M., Trawalter, S., Axt, J. R., & Oliver, M. N. (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proceedings of the National Academy of Sciences of the United States of America, 113(16), 4296–4301. https://doi.org/10.1073/pnas.1516047113
Nahin, R. L. (2017). Severe pain in veterans: The effect of age and sex, and comparisons with the general population. The journal of pain : official journal of the American Pain Society, 18(3), 247–254. https://doi.org/10.1016/j.jpain.2016.10.021
Poleshuck, E. L., & Green, C. R. (2008). Socioeconomic disadvantage and pain. Pain, 136(3), 235–238. https://doi.org/10.1016/j.pain.2008.04.003
Treede, R. D., Rief, W., Barke, A., Aziz, Q., Bennett, M. I., Benoliel, R., Cohen, M., Evers, S., Finnerup, N. B., First, M. B., Giamberardino, M. A., Kaasa, S., Kosek, E., Lavand’homme, P., Nicholas, M., Perrot, S., Scholz, J., Schug, S., Smith, B. H., … Wang, S. J. (2015). A classification of chronic pain for ICD-11. Pain, 156(6), 1003–1007. https://doi.org/10.1097/j.pain.0000000000000160 research paper writing help.
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