Perceptions of pain
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Research shows that African-Americans generally have a higher pain tolerance than most people. Moreover, many are under-treated for chronic and acute pain, causing their health to decline. Staja Booker wants to find ways to help African-Americans receive better chronic pain care.
Booker, a doctoral student in the College of Nursing at the University of Iowa from Jonesboro, La., believes that providing quality pain management for African-Americans requires gaining an understanding of their unique cultural perceptions and life experiences related to pain. Such information will be important, Booker says, in helping patients and their medical practitioners make good pain management decisions.
“This includes educating patients on the various treatment strategies and the effects of under-managed pain,” Booker says. “In addition, there is a need to educate health care providers, especially primary care providers who most likely are not skilled, according to current best evidence, about effective pain assessment and treatment in diverse populations or on the effect of culture and health literacy on informed decision-making and pain perception and processing.”
Booker asks, “What is really needed to ensure that their treatment plan is effective for their individual pain needs?” In her research, Booker will follow the medical progress of older African-Americans who don’t seek regular pain care, examining factors that affect these patients’ preferences in the treatment of pain.
In clinical practice, she observed differences in how African-Americans express, communicate, and seek treatment for pain. She verified this observation with previous research, showing that African-Americans attribute different meanings to and causes for pain. They also experience greater pain severity and duration.
As a master’s student at Penn State University, Booker began to focus more on the pain experience in African-Americans. Booker, a Dean’s Graduate Research Fellow, is pursuing her doctorate under the mentorship of Professor Keela Herr, co-director of the Hartford Center for Geriatric Nursing Excellence.
More pain means more health problems
Older African-Americans are at a higher risk than most people of receiving inadequate pain management, which leads to further health complications and declines in physical function, emotional and cognitive status, and social life.
But many of the factors that contribute to disparities in pain management in older African-Americans are under-researched.
“Although pain is one of the top reasons why people seek medical care, there is significant under-utilization of pain care services by African-Americans,” Booker says. “This leads to under-management and mismanagement of pain, resulting in huge personal and ethical issues and economic costs. This is why long-term, cost-effective strategies to reduce pain disparities in older African-Americans are highly needed.”
Making headway in the field of pain management
This fall, Booker presented her research at four conferences: the Council for the Advancement of Nursing Science, the Gerontological Society of America, the National Gerontological Nurses Association, and the NIH-NIMHD sponsored Science of Eliminating Health Disparities Summit.
“(Booker) was very active in her master’s program and was already doing scholarly activities that early doctoral students are doing,” Herr says. “She is definitely on the fast track to build her area of expertise and be recognized in her field. I was very impressed by her initiative and experiences and her approach to thinking about what she could do next.”
“I hope that my research as a Ph.D. student can help advance my long-term goal of identifying more culturally-appropriate and acceptable pain treatment practices and strategies for older African-Americans,” says Booker. “I hope it will improve quality of life in ethnogeriatrics.”
Booker’s research has been supported by the Graduate College’s Dean Graduate Research Fellowship Program and a Graduate Student Senate Travel Grant.
Read about life experiences that inspired Staja Booker to pursue this research.