Evidence Based Pain Management Tools to Guide the Mexican American Family Cancer Caregiver

Abstract

Hispanics in the United States, the majority of which are Mexican American (MA), experience high cancer incidence and mortality. This often leads to home care by a MA female caregiver (MAFCG). MA cultural and linguistic views, combined with low literacy often found in this ethnic group, may affect health care learning contributing to health care disparities. Limited evidence exists about culturally sensitive cancer pain management in MAs. Within this honors project, the author's aim was to answer the clinical question: What is the best (evidence-based) practice to promote comfort in MAs experiencing cancer-related pain? Research methodology included a structured integrative literature review process informed by Leininger's Theory of Transcultural Nursing and theoretical and operational definitions of pain within the context of the MA culture. The author appraised citations for credibility, clinical significance, and applicability for inclusion in evidence to meet the study aim. Evidence supported development of a bilingual (English and Spanish) pain management script assessed by a bicultural consultant, tested with two to three MAFCGs, and delivered by promotoras-de-salud (Texas Certified Community Health Workers). Findings included MAFCG reception of the script as culturally relevant, "complete," "very valuable," and at a literacy level helpful to understand ways to manage a family member's cancer-related pain. Additional MAFCG feedback prompted the author to develop two five-minute You-tube videos on cancer-related pain to improve information access and reinforcement in a low-literacy population that learns better through audio visual formats. Findings influence clinical practice by offering an evidence-based low-literacy script and video deemed helpful and culturally relevant by MAFCGs to increase their ability to promote pain management in a loved one with cancer. Increased caregiver understanding may improve partnerships between caregiver, ill family member, and health care provider for culturally tailored care for MA families during cancer.