Concepts Within the Chinese Culture That Influence the Cancer Pain Experience

Lih-Mih Chen, RN, PhD; Christine Miaskowski, PhD, RN, FAAN; Marylin Dodd, PhD, RN, FAAN; Steven Pantilat, MD

Disclosures

Cancer Nurs. 2008;31(2):103-108. 

In This Article

Abstract and Introduction

The purpose of this article is to describe some of the concepts within the Chinese culture that influence the sociocultural dimension of the cancer pain experience. The major concepts that influence Chinese patients' perspectives on cancer pain and its management include Taoism/energy, Buddhism, and Confucianism. Within the beliefs of Taoism/energy, pain occurs if Qi, or blood circulation, is blocked. To relieve pain, the blockage of Qi/blood must be removed and the person needs to maintain harmony with the universe. Within the beliefs of Buddhism, pain/suffering is a power, unwanted but existent, that comes from a barrier in the last life; from the objective world; from a person's own sensation; or from other people, animals, and materials. Only by following the 8 right ways (ie, right view, right intention, right speech, right action, right livelihood, right effort, right mindfulness, and right concentration) can an individual end the path of pain/suffering. A Confucian believes that pain is an essential element of life, a “trial” or a “sacrifice.” Therefore, when a person suffers with pain, he or she would rather endure the pain and not report it to a clinician until the pain becomes unbearable. Oncology nurses who care for Chinese patients need to understand the fundamental beliefs that influence the sociocultural dimension of the pain experience for these patients. This information will assist the oncology nurse in developing a more effective pain management plan.

In 1983, Ahles and colleagues[1] developed the multidimensional model of the cancer pain experience that included 5 dimensions: physiological, sensory, affective, cognitive, and behavioral. In 1987, McGuire[2] updated this model by adding a sixth dimension, namely, the sociocultural dimension. These 6 dimensions of the cancer pain experience were confirmed in a study of 40 cancer patients.[3]

McGuire suggested that the sociocultural dimension of the cancer pain experience included demographic characteristics (eg, age, sex, and race), ethnic background, and cultural, spiritual, religious, and social factors that influence individual's perceptions of and responses to pain. Cultural background is an important aspect of the sociocultural dimension of pain because persons from different cultures perceive and respond to pain in different ways. In addition, how and whether people communicate their pain to healthcare professionals and to others can be influenced by cultural factors.[4] Finally, perceptions of, responses to, and communications about pain can influence patients' use of pharmacological and nonpharmacological interventions.

The purpose of this article is to describe some of the concepts within the Chinese culture that influence the sociocultural dimension of the cancer pain experience. Clinicians who care for Chinese patients with cancer pain need to understand these concepts for them to provide culturally sensitive care to this patient population.

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