The meanings of and attitudes about cancer pain among African Americans.

PURPOSE/
OBJECTIVES: To describe the meaning of cancer pain and attitudes in dealing with cancer pain among a group of African Americans with cancer. RESEARCH APPROACH: Qualitative descriptive design.
SETTING: Three outpatient medical oncology clinics in the mid-Atlantic region. PARTICIPANTS: Purposive sample of 35 self-identified African Americans older than age 18 and diagnosed with solid tumors, with self-reported cancer-related pain lasting at least one month in duration and no major surgery in the previous three months. METHODOLOGIC APPROACH: In-depth, semistructured, taped-recorded interviews were transcribed verbatim and analyzed. Initial codes were categorized into meaningful themes, and the data were analyzed until no new themes emerged.
FINDINGS: Cancer pain was articulated by participants in terms of its physical, emotional, and existential dimensions. Themes related to cancer and pain remained intertwined. Some participants viewed pain as a signal of underlying disease progression and described it as a monitoring strategy for staying ahead of their cancer. Stoicism, faith, and finding meaning in the cancer pain experience emerged as main themes in participants dealing with cancer pain.
CONCLUSIONS: The findings suggest that perceived meanings and interpretations of the nature of cancer pain, its causes, and consequences may be important in shaping participants' pain treatment negotiations with providers. Understanding patient-level factors is crucial to fully comprehend pain treatment disparities.
INTERPRETATION: Providers must assume a more proactive role in assessing physical, emotional, and existential dimensions of cancer pain, improving trust and communication, and identifying educational and behavioral interventions for African American patients and families to optimize pain treatment outcomes.