Sociocultural Context of Pain Management in Oncology and Palliative Nursing Care

Pain management is a question of quality of life and
an indicator for nursing quality. Chronic pain which is predominant
in oncology and palliative nursing situations is perceived today as a
multifactorial, individual emotional experience with specific
characteristics including the sociocultural dimension when dealing
with migrant patients. This dimension of chronic pain is of major
importance in professional nursing of migrant patients in hospices or
palliative care units. Objectives of the study are: 1. To find out more
about the sociocultural views on pain and nursing care, on customs
and nursing practices connected with pain of both Turkish Muslim
and German Christian women, 2. To improve individual and family
oriented nursing practice with view to sociocultural needs of patients
in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women,
Turkish Muslims immigrants (4 from the first generation, 5 from the
second generation) and German Christian women of two generations
(5 of each age group) of the same age groups as the Turkish women
and with similar educational backgrounds were interviewed (semistructured
ethnographic interviews using Spradley, 1979) on their
perceptions and experiences of pain and nursing care within their
families. For both target groups the presentation will demonstrate the
following results in detail: Utterance of pain as well as “private” and
“public” pain vary within different societies and cultures. Permitted
forms of pain utterance are learned in childhood and determine
attitudes and expectations in adulthood. Language, especially when
metaphors and symbols are used, plays a major role for
misunderstandings. The sociocultural context of illness may include
specific beliefs that are important to the patients and yet seem more
than far-fetched from a biomedical perspective. Pain can be an
influential factor in family relationships where respect or hierarchies
do not allow the direct utterance of individual needs. Specific
resources are often, although not exclusively, linked to religious
convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to
the relevant literature and present nursing interventions and
instruments beyond medication that are helpful when dealing with
patients from various socio-cultural backgrounds in painful end-oflife
situations.

Authors:

• Andrea Zielke-Nadkarni

Keywords:

• Pain management
• migrants
• sociocultural context
• palliative care.

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