The nurses should be attentive and sensitive to the patients’ own cultural background especially when they work in diverse society. Cultural incompetency can result in inadequate or inappropriate care due to miscommunication and the possibility to make inaccurate assessments. Thus, cultural competence is linked to improving the quality of pain management as part of the patient care provided (Al-Atiyyat, 2009).
Patients with cancer pain should be cared by nurses who are culturally competent and who refrain from stereotyping while providing holistic care to patients. Campbell, Edwards, and Fillingim (2005) showed that there are no racial or ethnic differences in sensation threshold but the expression of pain is culturally-driven. The care provider should not impose their beliefs on the patients and they should be aware to the cultural differences in reports and treatment of pain (Al-Atiyyat, 2009).
Only a few studies have addressed cultural factors on pain among patients with cancer.
In a cohort study, Rabow and Dibble (2005) explored ethnic and country of origin differences in pain among outpatients with terminal and end-stage chronic illness among patients with cancer.
Although patients of all ethnicities are inadequately treated for their pain, African American cancer patients reported more pain than white patients, but no significant ethnic group differences in pain were found comparing Asian, black, and Latino patients. In a cross-sectional and descriptive study on 281 patients in an outpatient clinic in a large urban cancer center, the effect of perception of control over pain on disparities in pain in white and black patients with cancer was examined (Vallerand, Hasenau, Templin, & Collins-Bohler, 2005). The investigators found that African Americans patients had significantly higher pain intensity than white patients. They emphasized that perception of control over pain is an imperative factor to consider in understanding responses to pain.
Given these limited number of findings, it is necessary to
Cultural incompetence could lead to inaccurate understanding of patients’ statements and verbal or nonverbal communications, which may result in inappropriate assessment, diagnosis, and treatment behaviors (Al-Atiyyat, 2009).
Cultural considerations are vital in providing nursing care. When nurses generalize their own cultural stereotype and believe without considering the ones for their patients, this might affect patient care outcomes. Researchers have shown that nurses react differently to patients from a different culture even when patient expressions for the pain experience were the same (Edwards, Moric, Husfeldt, Buvanendran, & Ivankovich, 2005).
Ethnocentrism, the tendency to believe that one’s own beliefs and values are centrally important, prevents an understanding of the viewpoints of another culture (Al-Atiyyat, 2009).
Nurses need to be sensitive to a patient’s culture, to their own couture, and to potential discrepancies.
Such understanding of cultural similarities and differences can help nurses in better prevent problems related to interpersonal communication ambiguities that lead to insufficient and adequate control of pain (Beach, Saha, Cooper, & Commonwealth, 2006).