Understanding Cancer Pain Management Experiences and Needs of Chinese Migrants in Australia: A Mixed-Method Research Project

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𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱 Globally, pain occurs in more than half of cancer patients. Cultural beliefs and attitudes influence the way that people with cancer experience and report pain, and their pain management preferences. Chinese migrants are the largest non-English speaking population in Australia. However, little is known about their experiences and needs related to cancer pain and its management. 𝗔𝗶𝗺 To explore the pain-related experiences and needs of Chinese migrants with cancer pain who are living in Australia, and how they are influenced by culture. 𝗠𝗲𝘁𝗵𝗼𝗱𝘀 An integrated theoretical framework of Leininger’s ‘Theory of Culture Care Diversity and Universality’ and the ‘Australian Guidelines for Cancer Pain Management in Adults’ underpinned this convergent mixed methods doctoral project. The project was conducted over three phases, involving: a systematic review of Chinese and English literature on pain- related experiences and needs of people with cancer from Chinese backgrounds; a series of focus groups with Chinese migrants living with cancer pain, with an embedded survey (the Chinese version of the Barriers Questionnaire); a cross-sectional survey of cancer and palliative care nurses which explored their perspectives on managing cancer pain in Chinese migrants; and data integration. 𝗥𝗲𝘀𝘂𝗹𝘁𝘀 The systematic review identified that people from Chinese backgrounds experience similar levels of pain to other people with cancer and face similar barriers, including a reluctance to report pain and a fear of opioid addiction and side-effects. However, the focus group findings and survey results suggested that Chinese migrants living in Australia may have additional cultural and social reasons for not reporting pain or wanting to take opioids, and preferring to use non-pharmacological approaches that integrate traditional Chinese medicine and other complementary strategies. Findings suggest that patient education in bilingual and culturally appropriate formats aimed at encouraging help-seeking for pain and health professional education to build cultural competencies may be the key to overcoming barriers to effective pain management. 𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻 While Chinese migrants with cancer pain have similar cancer pain management fears and needs to other people living with cancer, the drivers are different and are largely attributable to a range of ‘cultural and social structural factors’. Applying the framework of Leininger’s ‘Sunrise Enabler to Discover Culture Care’ and ‘Semi-Structured Interview Guide Enabler to Assess Culture and Health’ assisted with understanding the needs of this migrant population. It also enabled the generation of a series of strategies designed to promote culturally congruent care, to help Chinese migrants living in Australia with cancer pain achieve the holistic wellbeing they desire and deserve.
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