Integrated Care for Pain Management Among Hispanic Populations
The management of pain continues to challenge health care providers and the health care system with high direct expenditures for medical care and medication related to pain and the indirect costs associated with lost productivity in the work force. This h
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Integrated Care for Pain Management Among Hispanic Populations Gwen Sherwood and Jeanette A. McNeill
Introduction The management of pain continues to challenge health care providers and the health care system with high direct expenditures for medical care and medication related to pain and the indirect costs associated with lost productivity in the work force. This has contributed to a “pain crisis in America” (Meghani, Byun, & Gallagher, 2012, p. 150) and resonates globally. Researchers report community populations may have a pain prevalence as high as 40 % noting minority members are overrepresented and more frequently undertreated (Mossey, 2011). Hispanic populations may present unique considerations that derive from the diversity of multinational backgrounds with strongly held values and beliefs and cultural perspectives. The purpose of this chapter is to explore the pain management experience of Hispanic populations, examine a quality improvement approach, and propose evidence-based integrated care solutions for more effective approaches.
G. Sherwood, Ph.D., R.N., F.A.A.N., A.N.E.F. (*) School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA e-mail: [email protected] J.A. McNeill, Dr.P.H., R.N., C.N.E., A.N.E.F. School of Nursing, University of Northern Colorado, Greeley, CO 80639, USA © Springer International Publishing Switzerland 2016 L.T. Benuto, W. O’Donohue (eds.), Enhancing Behavioral Health in Latino Populations, DOI 10.1007/978-3-319-42533-7_12
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G. Sherwood and J.A. McNeill
Managing Pain in Hispanic Populations Pain is one of the primary reasons people seek health care; it can be a symptom of a condition in the body requiring treatment. Treating the accompanying pain may be in addition to treating the condition and may invoke other responses and reactions due to both long held beliefs and attitudes on the part of the patient and family but also for health care providers.
Perspectives on Pain The varied nature of pain is one factor in the conundrum of managing pain effectively, and particularly for vulnerable populations. Pain is a subjective experience with multiple definitions. A common definition comes from the International Association for the Study of Pain which defines pain in terms of an unpleasant and emotional sensory experience associated with actual or potential tissue damage (2012); pain is therefore both a physical experience but also has a psychological and subjective context. McCaffery is credited with an oft quoted classic definition of pain as whatever the person who has pain says it is (Herr, Coyne, McCaffery, Manworren, & Merkel, 2011). As such, pain can best be explained with a biopsychosocial model that begins with the noxious stimulus, awareness that the stimulus is pain, followed by recognition from the brain of these signals as emotional and cognitive factors that determine perceptions of pain; these responses drive how one responds to pain including facial or verbal expressions and ultimately the decision to seek attention to re
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