Predictors of Pain Management among American Indian Cancer Survivors

Abstract

There is little research on cancer symptom management among Indigenous populations. This paper reports on the predictors of cancer pain management among American Indian cancer patients/survivors and their caregivers/family. The intervention was a symptom management toolkit delivered via traditional talking circles vs. standard care (control) at eight randomized reservation and urban clinic sites in the Southwest. Participants (N=184) were American Indian adults diagnosed with cancer and/or caregiver/family members. The primary outcome measure collected via pre-test and post-test questionnaires was the ability to manage cancer pain. Significant differences at post-test were the ability to manage cancer-related pain (p=.02) and a close relationship (p=.0018) that proved significant for intervention participants and was instrumental in fostering their ability to manage pain. The study also showed improvement in the desire and ability to improve cancer pain management among intervention participants. Programs targeting American Indians should use culturally appropriate education to improve management of cancer-related symptoms.

The cultural constructs of cancer-related fatigue among American Indian cancer survivors

“…As with other studies, participants understood that CRF was hard to treat and did not respond to rest. Our research concurs with the literature that support from family members and providers may be improved with education and the knowledge of the impact of CRF that often results in pain, suffering, and stigma [27,28]. The perception of a fatigued survivor need not carry the stigma associated with fatigue.…”

We Don’t Talk about It: Cancer Pain and American Indian Survivors

“…Later on, he just lowered his head and said, 'adalezy,' there is no hope. So he acknowledged it, but that was all he said about it" [14].…”

“…Cultural definitions of illness, perceptions of symptoms, treatment compliance, and health-seeking behaviors, as well as the delivery of health and prevention services [14] were important variables in this study. Culturally-bound illness beliefs and behaviors have a significant impact on mental health [15], thus awareness of the role of culture in communication, illness perceptions, and treatment beliefs, as well as the cultural value of self-reliance and the importance of respect and privacy among tribal groups were key topics of interest in this research.…”

Interventions to improve cancer survivorship among Indigenous Peoples and communities: a systematic review with a narrative synthesis

“…Quality assessments for the three experimental studies were moderate [23,49] and weak-moderate [69]; quasiexperimental studies were weak-moderate [55,58]; and nonexperimental studies were moderate (n=5) [45][46][47][48]57], weakmoderate (n=6) [42,43,54,65,68,70], and weak (n=2) [52,53]. For qualitative studies (n=5), three rated strong [51,60,66], one moderate [67], and one weak-moderate [59].…”

“…We identified seven different ingredients of the interventions: community meetings (n=8 studies) [23, 42-44, 47, 49, 54, 66]; patient navigation (n=8 studies) [45-48, 52, 56, 65, 67]; visual and performing arts (n=7 studies) [55,[58][59][60][61][62]64]; printed, online, or audio materials (n=7 studies) [23,49,55,56,60,63,68]; healthcare provider education (n=4 studies) [42,44,63,68]; support groups (n=4 studies) [50,51,57,67]; and telehealth (n=3 studies) [52,53,57]. Studies used one or two of the ingredients with just over half (n=14) using two ingredients.…”