Pain in the Hispanic Cancer Patient - Article Example

? “Estoy en un monton de dolor” Experiencing Pain from a Hispanic Cancer Patient’s Perspective The study of Im et al. (2007) shows serious implications to the medical sector. Disparity in the treatments received by cancer patients of Hispanic backgrounds as well as other migrant populations should be closely examined so that adjustment can be made to better cater to their needs. Equality is the foremost value that our country, the United States is known for and we must uphold that even for migrants. The study of Im et al is imperfect but it is an eye opener for people to wake up to the issues that are plaguing the health care system and thus denying fellow men of a right to proper pain management and care. Key words: Pain management, Hispanics, culture “Estoy en un monton de dolor” Experiencing Pain from a Hispanic Cancer Patient’s Perspective Though there are many flaws in the healthcare system in the United Stated, for many migrants especially African Americans and Hispanics, the existence of such a system is a great blessing. Many vie for immigrant status and citizenship to enjoy the privileges of social healthcare. The United States is a country that stood for equality of rights for every man, no matter the race, culture, or belief; however, it is shocking and disappointing to find out that there are discrepancies in the pain management options given to migrant cancer patients especially with regards to Hispanic cancer patients. I have known and seen a lot of people who had different types of cancer in the course of my life and in the academic degree that I chose. I have seen the tremendous amount of pain they experience especially those in the late stages of the disease. The pain relievers prescribed to them helps in improving their quality of life but it is sad even just to imagine that there are countless others, who are in the socio-cultural as well as socioeconomic minority that are needlessly experiencing excruciating pain when they already have the access to proper pain management options via the government’s healthcare system. The study of Im, Guevara, and Chee (2007) gives us a glimpse of how pain is handled by Hispanics. It also gives insights to the different factors that contribute to the inadequacy of pain management interventions that Hispanic cancer patients receive. By examining their research in a qualitative way, we can get insight on the value of understanding the sociocultural dimension of a cancer patient’s pain management, and thus help equalize the disparities in treatment given to Hispanics and other migrants. This will allow us nurses to give quality patient care to all mankind, as is our sworn responsibility. I. Hispanic Cancer Patient’s Pain as Described in the Article – Discussion and Critique As the authors’ examined the part that socio-cultural background plays in the experience of pain in Hispanic cancer patients, I was given a clear representation of how the healthcare paradigm works in for the case of migrants. I appreciate the effort that they gave in representing the “pain experience” as personal as possible by quoting actual forum responses of the cancer patients. This painted a picture that gets the reader to easily empathize with the patient and allows the reader to view how hard it is for Hispanic cancer patients to endure everyday with the pain that they bear. Although they presented the testimonies of their respondents well, there are certain aspects of their methodology that can be improved to make the implications of the study have more weight. (1) The sampling method used was convenience sampling which automatically results in biased data. The title of the study indicates that the author’s wanted to show insights for Hispanic cancer patients’ pain experience all over the United States; however they did not get representative samples for different States which is indicative that the finding could not be generalized to bear implications to the whole of the United States and the whole healthcare system. (2) The sample size is not enough to make statistically significant conclusions. The final number of participants at the end of the survey period was 15. The least number of participants for a survey to be statistically valid is 25 (Jackson, 2011). This also poses a big problem with the scope that their study wants to represent. As the title indicates, the study is representative of the collective experience of Hispanic cancer patients in the United States but with the estimated +50 million Hispanic individual all over the US and more than 47,000 new male and 51,000 new female Hispanic cancer patients all over the US (American Cancer Society, 2009), having a sample size of 15 is really not enough to encompass the projected scope of the study. (3) The survey method that they used can also lead to biased data and thus a misrepresentation of the sample population under study. The authors chose to accomplish their survey via online forum running for a period of six months. This mode limits the number of participants, as they have mentioned in their methodology, to only the Hispanic cancer patients with computer and internet access. If they really wanted to get a deeper and more realistic view on the pain experience of the underprivileged Hispanic cancer patients then they should have included in their interview those Hispanics that have no access to computers or the internet for they are most likely to fall in the category of the poorest of the poor and thus would create an avenue to view the other side of the spectrum. People with computer and internet access are more than likely to have better financial status and they also have a higher functional educational attainment than their counterparts that do not have computer and internet access. The consideration of this fact however can still give us insight from the population of Hispanic cancer patients with no computer and internet access, for if the views expressed in the study points to inadequacy in pain management for the more privileged patients, then we could just imagine how hard it would be like in the position of those patients without computer and internet access. The data gathered from this study was interpreted and analyzed using three perspectives: Cultural, gender-based, and economic. It was a good thing that the authors allowed the participants of the study to express themselves in their parent tongue and they had these responses translated to English then validated them with a re-translation into Spanish so that there would be congruence in the data expressed despite the language barrier. The use of the different perspectives in analysis was also participant based and not just according to the wiles of the authors. They’ve actually added a part in their survey in response to the request of the participants. This shows concern towards the patients and reinforces equality in races, and that they too, even though a minority has a voice. All in all, the analysis they had with the limited data that they have was good. And although I would have wanted to see more trends like responses to pain between males and females, and also pain treatment quality between well-to-do Hispanics and poorer Hispanics – their analysis and interpretations were thorough enough. I just think that the conclusion should be more limited in scope because they did not have enough number of participants to make a conclusive claim for the whole United States. The theory behind the study is founded and the results, though partial were indicative of a trend that need to be further investigated. The existence of a cultural discrepancy in the management of pain is a reality and this should be changed. But, there should be more studies along the lines that the authors took. They had the right attitude in conducting the study and they had the respect for their participants. This study is more of an eye opener rather than a statistically valid expose. What it lacked in validity, it made up for in adding the personal touch of the individuals who participated in the study. Making their plight personal is more likely to elicit responses from people to do something about the malpractice against immigrants and the constraints that lead to this malpractice. What the article of Im et al. (2007) offers is really just a call to action so that many more medical professionals will take notice of this problem and examine themselves too if they are doing the same damage albeit unintentional. It is a short cut for people in the healthcare system to provide quick answers that will benefit these people in need. II. Reasons for Inadequate Pain Management for Hispanic Cancer Patients Hispanic cancer patients are in need of proper treatment just like the rest of the American population, which is why the study of Im et al. (2007) was made. In their study, all of the factors or contributors to the problem were identified through the online forum survey. They collated all the findings and came up with four major thematic constraints that made it hard for Hispanic cancer patients to get adequate treatment for their pain. 1. Lack of Communication about under medication Language barriers that exist between their healthcare providers and the patient often complicate the communication process for the administration of proper pain treatment. Lack of financial resources also prompt patients to skip taking valuable medications for their treatment and pain management. Piousness in religion that results to stoic attitude towards cancer and pain as well as the reliance in alternative forms of medicine are also deeply rooted in their culture which becomes hindrances to the western healthcare system to better address their needs. 2. Macho Men and Abnegada The “macho” and the “abnegada” male and female (respectively) gender roles that made it in appropriate for both males and females (especially mothers) to express pain. It is considered shameful for the patient to cease to do their responsibilities due to the pain. 3. Family is more Important than Cancer Pain Close family ties work both ways because the support from their family eases the patient’s pain but then, the patient is also more likely to endure the pain so as not to worry their family and so as not to become a burden. 4. Feeling like a Prisoner The immigration status of Hispanics is a big issue in their pain medication as well as in the treatment of their cancer. Many are not yet citizen or are waiting for immigrant status and their health needs are compromised by this. Their race also predisposes them to racial prejudice by healthcare providers and their attitude that they would rather have what they are currently receiving though it’s unequal treatment, rather than assert their right to better service. III. Conclusions and Recommendations As was mentioned in the earlier part of the paper, modifications and additions to the sampling method and analysis will make this paper have more weight but as of the moment, it really lacks enough evidence to be conclusive. The research will really benefit from a better experimental design which will ensure the statistically validity of the research. More aspects should be evaluated like cancer stage of the patient, a bigger geographical search, and a wider sample size will ensure that the results will rightly represent the trends for Hispanics and their pain experience here in the United States. For us nurses and those in the medical field, let this be a reminder to us to be considerate of the socio-cultural and socio-economic backgrounds of our patients. Let us not be too concerned with protocol and earnings that we forget our responsibility to serve our fellow men. And further research on disparity in medical treatment received by those in the social minority should be conducted so as to help the legislative part of the government address this issue properly so that equality will be achieved. Let us look towards the day when a plea for help, would not be ignored and those that cry out in pain will be relieved. Reference American Cancer Society. (2009) “Cancer Facts and Figures for Hispanics/ Latinos 2009-2011”. American Cancer Society, Inc., 250 Williams Street, NW, Atlanta, GA 30303-1002. pp.1-32 Im, E. O., Guevara, E. and Chee, W. (2007) “The Pain Experience of Hispanic Patients with Cancer in the United States”. Oncology Nursing Forum. Vol. 34, No. 4, p.861-868 Jackson, S. L. (2011) “Research Methods and Statistics: A Critical Thinking Approach” 4th ed. Cengage Learning. p. 57-74 Read More