Pain is experienced by all individuals across all ages and cultures around the globe. However, it is defined differently according to the perception of the pain depending on the culture and the past experience. For instance, the International association of pain defines it as an “unpleasant sensory and emotional experience associated with actual or potential tissue damage.” (Linton, 2005, p.213). Comparatively, the Japanese culture defines it as “itami, means extraordinary state of something without containing the meaning of punishment.” (Hoka 2004). Furthermore, Hoka (2004), explains this is because the “Japanese who originally have view of life of empathy and assimilation with the nature, have tended not to regard the pain as the object being overcome.” (Hoka, 2004). This demonstrates the importance of culture and its influence on an individual’s experience in relation to the pain. Hence, understanding that culture and its relationship to the pain is necessary for the healthcare team to provide culturally sensitive and competent care because it “…represents behavior patterns or beliefs that define a group.” (Alverdo, 2008, p.4). Therefore, this paper will examine the nature of pain, the relationship between the chosen culture and pain and the nurses’ appropriate interventions. As suggested by Alvaredo (2008), “pain is best understood when culture is taken into to consideration.” (Alvaredo, 2008).
Natures of pain
Evidence show previously pain was accepted as a symptom of a diseases. However, “now pain is understood to be complex, and chronic pain is considered to be a disease in its own right.” (Potter, P. A., Perry, A. G., Hall, A., & Stockert, P. A., p.1018). It comprises of other factors such as “affective (emotional), cognitive, behavioral, and sensory components that are shaped by past experience, culture, and situational factors.” (Potter et al., 2014, p.1018). In addition, Potter et al (2014) state, the trigger for pain can be physical, psychological or both. The physical factors identified are; “pain threshold, pain tolerance, age, physical activity and nervous system integrity and surgery and anesthesia. Psychological factors that influence response to pain include culture, religion, past experiences with pain, anxiety and situational factors.” (Linton, 2005, p.215). An example of psychological pain can be a break up with a friend or a boyfriend, it does not necessarily have to have physical manifestation to be treated. As a nurse, our job is to provide healing in all aspects through compassion, understanding and empathy.
According Linton (2005), there are three types of pain widely recognized by the health care team, these are; acute that lasts 3-6months, chronic, which lasts longer than 6months and cancer related pain. Therefore, as a health care provider understanding these concepts about pain can aid in developing the right care of plan for the patient that caters to the patient’s needs.
Relationship between ethnic background and pain
In the Japanese culture “the belief that health and illness are determined from harmony and balance between oneself, society and the universe are foundations found within Shinto and Buddhism religions.” (Alvarado, 2008, p.25). As healthcare provider, one must acknowledge and familiarized oneself with this belief to provide a culturally competent care. Furthermore, it is also believed that pain is “result of imbalance, which may be lack of sleep, poor diet, or from loss of spiritual, family or environmental harmony.” (Alvarado, 2008). Therefore, identifying underlying cause of pain according to the patient’s culture is crucial to develop the appropriate course of treatment. These would include providing balanced diet, enough sleep and privacy to practice any rituals that the facility may allow. This not only shows respect to the client but also earns the trust of the client to build a therapeutic relationship between the healthcare provider and the patient.
In addition, the nurses should be aware of the belief that some older Japanese client may have, “illness can be warded off by seeking a priest.” (Alvarado, 2008, p. 27). It is the nurses’ duty to identify these beliefs and making the services available to the patient, which again may reinforce trust and compliance from client. This will help in providing quality of care while enhancing healing. Another aspect to be mindful of is spirituality which entails “by expressing thanks to nature, ancestors, and others taking care of each other; and having a peaceful outlook and hopefulness in the face of death. Faith, worship, prayer, search of inner peace and hope, and thanksgiving.” (Shirahama & Inoue, 2001., p. 72).