A multinational study of pain management among Hispanics

Abstract

A multinational project involving pain research teams from three countries examined pain management outcomes in Hispanics. The limited research on pain management outcomes in Hispanics are primarily from the USA, lacking the distinct multinational cultural influences. This article compares the descriptive analysis of the post-operative pain experience of Hispanics in the USA, Puerto Rico and Mexico and tests the reliability of a new Spanish language instrument, the Cuestionario de Houston Sobre el Dolor (Houston Pain Outcome Instrument, HPOI). There were similarities in expectations related to pain relief, proportion of patients reporting worst pain, usual pain and pain-related interference with function. Significant differences were found on adequacy of pain management. Participants reported high use of non-pharmacologic approaches, particularly prayer and family support. The newly developed instrument indicated acceptable reliability in all settings, Chronbach’s Alpha > 0.75, with some variability by study site. Further cross-ethnic and multinational research are needed to provide culturally relevant evidence-based practice models to overcome barriers and reduce disparity.

Postoperative Pain Management Outcome in Chinese Inpatients

“…There is a need for further study of the outcomes of postoperative pain management in mainland China. Shen et al / Postoperative Pain Management 977 Purpose This study replicated methods from Sherwood et al (2005) using the HPOI. The aims of this study were (a) to describe pain management outcomes for Chinese inpatients, including pain expectation, pain intensity, pain interference with function, patient education, and patient satisfaction with pain management and adequacy of pain medication, as measured by PMI scores, and with the nonpharmacologic methods patients used and (b) to determine the relationship between patient satisfaction and other clinical pain outcomes.…”

“…The HPOI was based on the prototype APS-POQ developed by the Quality of Care Committee of the APS and modified and refined using qualitative data obtained from interviews and focus groups . It was tested for validity by means of factor analysis, which yielded a five-factor solution explaining 81% of the variance in responses (Sherwood et al, 2005). The reliability (Cronbach's alpha) for the entire instrument was .87, and it demonstrated excellent convergent validity with an established instrument (the Brief Pain Inventory) and clarity.…”

“…The instrument has been administered by interview with an estimated readability of 5.5 (Flesch-Kincaid formula). In the multinational study by Sherwood et al (2005), the internal consistency of the tool varied somewhat by study site: (U.S. sample, .84; Mexican sample, .76; and Puerto Rican sample, .84).…”

“…Although the PMI was designed to evaluate the appropriateness of cancer pain management, several studies of acute pain management have established it as a useful indicator of adequacy in evaluating the range and appropriateness of pain treatments for hospitalized postoperative patients (McNeill et al, 2001;Sherwood et al, 2005;.…”

“…The HPOI was used in conjunction with the Pain Management Index (PMI), a tool to evaluate the adequacy of pain medications ordered (Cleeland et al, 1994). Results from the HPOI have been obtained from Mexican Americans in Mexico, Puerto Rico, and the southwestern United States (Sherwood, McNeill, Hernandez, & Penarrieta, 2005). These results did not differ significantly from those of prior studies using the APS-POQ with English speakers (McNeill, Sherwood, Starck, & Nieto, 2001;McNeill, Sherwood, Starck, & Thompson, 1998), in that patients continue to experience pain yet report high satisfaction with pain management.…”