Voices of African American Older Adults on the Implications of Social and Healthcare-Related Policies for Osteoarthritis Pain Care.

BACKGROUND: Chronic pain is a distressing symptom that older adults with osteoarthritis (OA) seek to minimize through management. Research consistently points out the disparities that older African Americans face when managing chronic pain conditions, but a major gap in the literature is how pain care policy at the federal, state, and local level protects or exposes older African Americans to disadvantaged care. AIMS: The purpose of this original research is to examine policy issues and care enhancement opportunities that emerge from the narratives and personal stories of older African Americans living with chronic OA pain.
DESIGN: A secondary qualitative data analysis.
METHODS: African Americans (≥50 years) with OA pain living in Louisiana were interviewed to gather global perspectives and specific information about how they manage OA pain. Narrative analytic techniques were applied to 18 individual, semistructured interviews.
RESULTS: Three policy-related pain management issues and implications surfaced from the older African Americans' rich narratives: (1) "Access to and navigation of the healthcare system," (2) "Affordability of natural supplements, medications, and treatments," and (3) "Expansion of pain palliative care and community programs."
CONCLUSIONS: African American older adults face numerous challenges in managing pain well. Navigating the healthcare system is an abiding issue, and perceived injustice in care was a common thread throughout the narratives. On the positive side, older African Americans also proposed practice- and policy-related solutions to counter the pain treatment challenges. Nurses are natural advocates for patients, and should work to change healthcare policies that unfairly marginalize ethnic/racial older adults' long-term ability to manage chronic pain.