Pain in Underserved Community‐Dwelling Chinese American Cancer Patients: Demographic and Medical Correlates

Learning Objectives After completing this course, the reader will be able to: Discuss the prevalence of frequent or persistent pain among non‐English‐speaking Chinese American cancer patients. Identify factors that were significantly associated with increased pain intensity and pain‐related distress in the population studied. This article is available for continuing medical education credit at CME.TheOncologist.com Background. Little is known about cancer pain in Chinese Americans. The objective of this study was to describe the epidemiology of pain in this population. This information is needed to identify and address unmet clinical needs for culturally relevant interventions targeting pain and its consequences. Methods. A consecutive sample of underserved ethnic Chinese patients in a large community‐based oncology practice was screened for persistent or frequent pain. Those patients with pain completed translated instruments assessing demographics, linguistic acculturation, disease‐related characteristics, and pain‐related characteristics. Results. Of 312 patients screened, 178 (57.1%) reported frequent or persistent pain, 175 were eligible, and 170 participated. Most participants (85.9%) were born in China and 84.7% overall spoke Cantonese only. The most common cancers were gastrointestinal (28.2%), lung (21.8%), breast (20.6%), head and neck (12.9%), and genitourinary (4.7%); 43.5% had metastatic disease. The mean worst pain severity on a 0–10 numeric scale was 4.7 (standard deviation, 2.4), with 28.2% of patients rating their worst pain at ≥7 of 10. Although 37.6% used opioids and 47.1% used nonopioids, 45.8% reported “little” or “no” pain relief from medications. Complementary or alternative medicine therapies for cancer pain were used by 35.8%. In multiple regression analyses, worst pain was positively associated with acculturation to the English language and opioid therapy, and pain‐related distress was positively associated with opioid therapy. Conclusion. Pain is prevalent among community‐dwelling, ethnic Chinese American cancer patients. Additional studies are needed to confirm these results and investigate the finding that higher linguistic acculturation is associated with reports of more intense pain. 摘要 背景. 关于美国华裔的癌症疼痛资料很少见诸报道，本研究的目的是探讨华裔中癌症疼痛的流行病学。该研究对了解此人群疼痛治疗临床需求及文化适应性对其影响是非常必要的。 方法. 在一家服务匮乏的大型社区肿瘤医疗机构，从华裔患者连续样本中筛选持续或频繁疼痛病例。筛选出的疼痛患者，填写中文版的评定工具，以评估其人口统计学数据、语言文化适应程度、疾病相关特征和疼痛相关特征。 结果. 312例患者参与筛选，其中178例（57.1%）有频繁或持续疼痛，175例符合标准，170例入组研究。入组的多数患