Review of literature on culture and pain of adults with focus on Mexican-Americans

Abstract

The purposes of this paper are to review the literature on culture and pain in adults, and specifically on Mexican-American beliefs about pain, and nurses' responses to patients' pain. Nurses and other health caregivers in the United States often characterize various ethnocultural groups according to their reaction to pain and their ability to tolerate pain. Cross-cultural studies have demonstrated that White Americans of Northern European origin react to pain stoically and as calmly as possible, choosing to withdraw if pain becomes intense. This response to pain has become the cultural model or norm in the United States. It is the behavior expected and valued by health caregivers. Mexican-Americans are often described as complainers who want immediate relief for their pain. Yet studies of Mexican-American culture and cross-cultural studies of the pain experience and responses of Mexican-Americans do not support this characterization. Nurses and patients assess pain differently regardless of cultural background. Both nurses and physicians tend to underestimate and undertreat the pain of their patients when compared to patients' assessment of pain. However, the ethnicity and culture of the patient influence the extent of difference between the patient's and nurse's assessment. The culture of the nurse also influences the inference of patients' physical pain and psychological distress. Based on the studies reviewed, implications are drawn for transcultural nursing practice and recommendations are made for future nursing research.