Understanding the cancer pain experience in American Indians of the Northern Plains

Objective: The purpose of this study was to explore the experience of cancer pain in American Indians (AI) from the Northern Plains region of the United States. Design: This was a qualitative descriptive study. Setting: Southeastern Montana. Participants: The sample consisted of 10 participants from Northern Plains AI tribes/nations, aged 31-75 years, with both solid and hematologic malignancies. Main outcome measures: Data were produced through semi-structured interviews and through the use of the Brief Pain Inventory-Short Form. Results: Participants reported mild-to-moderate pain on a daily basis, and pain negatively interfered with their daily activities and enjoyment of life. The average pain score at the time of interview was 4.2 out of 10. Participants described both somatic and neuropathic pain. Participants reported psychosocial distress through feelings of guilt, depression, and isolation related to their cancer, and they relied strongly on prayer and traditional medicine in coping with pain. Dominant themes were 'Isolating Within' and 'Making Connections'. Conclusions: This study suggests that there is very little difference between AI and other cultural groups regarding cancer pain in the description of pain, patterns, and types of pain management. However, this study identified notable differences in the high degree of isolation reported by AI, their desire to endure pain with stoicism, their intense desire to protect their privacy, and their distrust of outsiders. Findings from this study will inform future research on pain and pain interventions in AI patients with cancer. Copyright (C) 2010 John Wiley & Sons, Ltd.